If you have MS, is it time to get another COVID-19 booster?

The recommendations all seem to be pointing in a clear direction for me

by Ed Tobias | April 28, 2023

Those with multiple sclerosis (MS) may want to roll up their sleeves again for a COVID-19 vaccine. I’m thinking about whether to join them.

About 10 days ago, an advisory committee of the U.S. Centers for Disease Control and Prevention (CDC) supported a recommendation that people 65 and older and those with compromised immune systems get another booster, if at least four months have passed since their last one for those 65 and older, and at least two months have passed for those who are immunocompromised. What does this mean for me and other people with MS?

MS associations recommend the vaccine

The National Multiple Sclerosis Society, the MS Trust, the Consortium of Multiple Sclerosis Centers, and others have long recommended that those with MS get a COVID-19 vaccine, particularly those whose immune systems may be depleted by a disease-modifying therapy. These associations believe a case of COVID-19 could be more serious for those with MS than for the average person.

Time for COVID-19 Boosters and Seasonal Flu Shots

It’s the same booster as last year

This most recent recommendation is for a second shot of the same booster that became available in late 2022. It’s the bivalent mRNA booster that’s made by both Moderna and Pfizer-BioNTech, and it covers both the original strain of SARS-CoV-2 and the more recent BA.4/BA.5 variants.

The CDC now recommends this shot even for people who’ve never received a COVID-19 vaccine.

My vaccine experiences have all been good

My wife and I have received all five of the COVID-19 vaccine shots available so far: the original series of two shots plus three boosters. Our most recent was about six months ago. We had minimal side effects, limited mostly to fatigue, a sore arm, and a slight fever for a day.

Even so, COVID-19 caught up with me in February — but only a mild case. I attribute that to the high antibody levels those vaccinations produced. I know they were high because I’d been tested.

Vaccines create COVID-19 antibodies

After my first two vaccines in January and March 2021, my neurologist drew blood for a test that showed my COVID-19 antibody level was greater than 2,500 units per milliliter (U/mL). According to my lab report, a result of just 0.8 U/mL or higher indicates the presence of SARS-CoV-2 antibodies. An article written at that time by the manufacturer of one antibody test reports that my 2,500 number indicated a robust vaccination response.

I had blood drawn for another antibody test in October as part of a research study. Again, those results showed a high antibody level.

Recommendations vary a bit

With all of those antibodies likely still floating around in my bloodstream, and probably my wife’s, should we get another shot? Our primary care physician recommends we get one, my neurologist says it’s up to me, and the U.S. Food and Drug Administration (FDA) says people 65 and older who’ve received a single dose of a bivalent vaccine may receive one additional dose if at least four months have lapsed since that shot. That’s the case for both of us.

The FDA also says most immunocompromised people who’ve received a bivalent COVID-19 vaccine may receive a single additional dose of that type of vaccine if at least two months have passed, and additional doses may be administered at the discretion of, and at intervals determined by, their healthcare provider.

Note that the space between shots can be shorter for people with suppressed immune systems. Also note that the FDA says “may receive,” not “should receive.” That’s a weaker statement than it’s made in the past. But the agency also cautions that “COVID-19 continues to be a very real risk for many people.”

To get or not to get the booster is the question

My wife and I are not immunocompromised, but we’re both well past age 65. And of course, a heavy attack of COVID-19 could really knock my MS for a loop.

I think we’ll both wind up getting our sixth COVID-19 vaccination. In fact, I think it’ll become a yearly routine for us, just like we get our seasonal flu shot. It seems as if the potential benefits outweigh any possible risk or inconvenience.

You’re invited to visit my personal homepage at www.themswire.com.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

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About the Author

Ed Tobias People say to write what you know and Ed Tobias knows about MS. He's lived with the illness since 1980, when he was 32 years old. Ed's a retired, award-winning broadcast journalist and his column combines his four decades of MS experiences with news and comments about the latest in the MS community. In addition to writing his column, Ed is one of the patient moderators on the MS News Today Facebook, Twitter, and Instagram sites. He’s also the author of “The Multiple Sclerosis Toolbox: Hints and Tips for Living with M.S.” Ed and his wife split their time between the Washington, D.C. suburbs and Florida’s Gulf Coast, trying to follow the sun.

Comments

Raegan Spence

I’m with you on this, in fact I just had my 6th vaccine yesterday. I believe the benefits outweighs the risk for myself at this point. Great article 😊

Ed Tobias

Thanks, Raegan. At this point, as my neuro told me, it's really an individual choice. I expect I'll get one, but I'm not in a rush, as I was to get the others.

Mike Draggich

Wife is 74 with PPMS and has received every Covid booster and every time had a severe flareup of her MS that lasts couple days. Had to be hospitalized one time. She doesn't want the mrna vaccine again.

Ed Tobias

Hi Mike,

Thanks for sharing that info and I'm sorry about your wife's flares. I wonder if the vaccine caused a fever, which is not out of the ordinary, and if her advanced MS made her more sensitive to that fever. Just guessing. I'm not a doctor. Anyway, she needs to do what the feels is best.

Chris Martin

Why is there no discussion about the possible side effects of medical intervention, including vaccines?

We, as a society, haven't much talked about this except in politically charged arguments.

Also you state that "These associations believe a case of COVID-19 could be more serious for those with MS than for the average person." Isn't there enough data now that the CDC should be able to say definitively? I have read that MS patients who got covid did not suffer greater challenges than people without MS. That's old data though.

Thanks for the article, this remains something for me to consider both risks and rewards. I hope that none of us get Covid again.

Regards - Chris

Ed Tobias

Hi Chris,

My apologies for the delayed posting of your comments. There have been a few studies of COVID-19 and MS within the MS community. One that MS News Today had a story on only about two months ago reported that "infection with the virus that causes COVID-19 significantly accelerates neurological disability in people with multiple sclerosis (MS), at least in the first months after infection, a study from Belgium reported. A more severe case of COVID-19, one requiring hospitalization, also significantly associated with a faster worsening of MS symptoms, its researchers noted. While being vaccinated against COVID-19 protected patients from a more severe infection, it did not prevent a faster accumulation of disability."

Here's a link to the full story: https://multiplesclerosisnewstoday.com/news-posts/2023/03/22/greater-ms-disability-patients-covid-19-infection/

Leanne Broughton

I just had my 6th vaccine.yesterday. I consider it a necessary evil. I have not had a usual fever, which greatly affects my mobility. Fingers crossed.

Ed Tobias

My fingers are too, Leanne.

Luke Maynard

Hi Ed,

Thanks for taking the time to share all this. I've been following the stats carefully, both nationally (I'm in Canada) and globally, and what I've noticed is that while infection rates are holding steady, death rates have substantially declined since the beginning of last year. I attribute that to widespread vaccination.

One thing to note is that "vaccines" are all different, and so are people. This one doesn't magically prevent against COVID at all, the way certain other vaccines do. But it dramatically increases the mildness of cases, and ensures the people who get it (as I did too) have a much better time of it, and probably a much reduced chance of "long COVID" too.

As other responses indicate, some people have a worse response than others to the different vaccines, so we shouldn't necessarily judge for ourselves by what other people experience. After my response to the first three vaccine/boosters was fairly manageable, I've got a pretty good "baseline" for what to expect, and I have no reason personally NOT to get another shot.

If people have had a worse reaction to them, their bodies are not my bodies, and what works for me may not be best for them. But with RRMS that is (hopefully) headed into remission, I have no hurdles to staying protected, so I'm making an informed choice to keep myself fully boosted until something changes.

Ed Tobias

Hi Luke,

Thanks for your detailed comments and I apologize for the time it took for your post to appear. I agree with all that you've written. Our bodies are all different and what's good for one might not be as good, or it might even be bad, for another. But being well informed, getting info from reliable sources, is a key to making that decision.

Kristin

I have primary progressive MS and the second vaccination as well as both boosters have given me a day and 1/2 of being almost nonfunctional – very spastic and also Very weak. No fever, no fatigue, just a weird reaction to the injection. That said, the day after I have been back to baseline. I definitely will get another booster. The vaccine reaction is temporary but I can't run the risk of getting The virus and having it put my MS into high gear.

Ed Tobias

Hi Kristin,

That is, indeed, a strange reaction...at least to me as a person who isn't a healthcare professional. I know some people have reported bad reactions but, as I wrote, mine have been minor and I think that's the way it's been for most folks. So, we think alike about continuing to receive the booster.

Michele

definitely not for me - I have had RRMS for 26 years and on Gilenya for 15 - vaccine destroyed all my good work to keep MS at bay. Made everything that MS does to me exacerbate tenfold all at once - and the ringing in my ears since the first one is still there. We should have a choice - I had two so that I didn't lose my job and fought very hard not to have the third - I have not doubt about it being detrimental to me and I will not have another one.

Ed Tobias

Hi Michele,

Thanks for sharing your comments and I'm sorry for the problems you had.

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