In some people with multiple sclerosis (MS), certain vaccines can trigger symptom flare-ups. This leads some people with MS to wonder if they should get vaccinated against COVID-19. According to the National Multiple Sclerosis Society, the answer is yes: It’s safe and important for people with MS to get the COVID-19 vaccine. 

Learn more about the COVID-19 vaccine and MS, including side effects, effectiveness, and risks.

Benefits

The Food and Drug Administration (FDA) has fully approved or given emergency use authorization (EUA) to four COVID-19 vaccines in the United States:

  • Pfizer BioNTech COVID-19 vaccine: Available to people 6 months and older
  • Moderna COVID-19 vaccine: Available to people 6 months and older
  • Janssen/Johnson & Johnson (J&J) COVID-19 vaccine: Available to people 18 years and older
  • Novavax COVID-19 vaccine, Adjuvanted: Available to people 12 years and older

Updated bivalent boosters from Pfizer-BioNTech and Moderna have also received EUA from the FDA.

In general, the Centers for Disease Control and Prevention (CDC) recommends one bivalent booster dose for:

  • Everyone 5 years and older if it has been at least two months since their last doseChildren 6 months through 4 years who completed the Moderna primary series

Children aged 5 years who completed the Pfizer primary series can only receive the bivalent Pfizer booster. Everyone ages 6 years and older can choose to get the Pfizer or Moderna bivalent booster. 

The National Multiple Sclerosis Society also recommends that people with MS get vaccinated against COVID-19—preferably with Pfizer-BioNTech, Moderna, or Novavax—to prevent COVID-19 and related complications.

Recent research suggests that the COVID-19 vaccine is safe and effective for most people with MS. People with MS who get breakthrough COVID-19 infections—infections that occur in fully vaccinated people—have a significantly reduced risk of:

  • Hospitalization
  • Admission to a hospital intensive care unit (ICU)
  • Intubation (insertion of a tube through the mouth or nose and into the airway to help with breathing)
  • Death

Side Effects

Many people experience side effects from the COVID-19 vaccine. This is typically a sign that your body is working to build immunity against SARS-CoV-2. As reported by the CDC, the most common side effects of the COVID vaccine are:

  • Pain, redness, and/or swelling at the injection siteTirednessNauseaFeverMuscle painChills

A 2022 study revealed that 54.5% of people with MS experienced at least one side effect after receiving a third dose of the Pfizer-BioNTech COVID-19 vaccine. The most common side effects they reported were mild and short-lived, such as:

  • Muscle painJoint painPain at the site of injectionFatigueFever

Most side effects from the COVID-19 vaccine resolve on their own within a few days. If your side effects are not going away, reach out to your healthcare provider.

If you experience signs of anaphylaxis (a severe allergic reaction) shortly after getting the COVID-19 vaccine—with symptoms such as swelling, difficulty breathing, hives, or a rash—seek emergency medical help immediately.

Risks

Some people with MS are concerned about the potential risks of the COVID-19 vaccine, including post-vaccine MS flare-ups and the effects of MS medications.

How to Minimize Side Effects From the COVID-19 Vaccine

If you experience side effects from the COVID-19 vaccine, it is usually safe to take over-the-counter (OTC, without a prescription) medication, such as Advil (ibuprofen) or Tylenol (acetaminophen). If you experience pain in the area where you received the shot, arm movement and a cool, damp washcloth may help.

MS Flare-Ups

Some people with multiple sclerosis experience MS relapses after getting certain vaccines. In general, if you are currently experiencing an MS flare-up, you should wait until your symptoms are under control to receive the vaccine.

Research suggests that MS symptom flare-ups are rare after the COVID-19 vaccine. In one recent study, 3.8% of MS patients experienced a temporary flare-up after receiving a Pfizer-BioNTech booster shot. Meanwhile, only 3.3% of people with MS experienced a severe relapse after getting their third shot. 

According to the National MS Society, the COVID-19 vaccine is not likely to trigger an MS flare-up. For most people with MS, the benefits of vaccination outweigh the risks.

Disease-Modifying Therapies (DMTs) 

Many people with MS take disease-modifying therapies (DMTs) to slow down the progression of their disorder and control their symptoms. DMTs typically work by reducing the body’s natural immune response and level of inflammation.

Because they are immunosuppressants, DMTs can increase your risk of infection. They can also make certain vaccines less effective. People with MS who are taking DMTs should typically not receive live vaccines (vaccines that contain a weakened, or attenuated, version of a virus). 

However, the COVID-19 vaccine is not a live vaccine. Instead, both the Pfizer-BioNTech and Moderna COVID-19 vaccines are messenger RNA (mRNA) vaccines. They teach the body’s immune system to detect and fight off the SARS-CoV-2 virus using a copy of a blueprint for a certain protein. 

Most people who take DMTs to control MS symptoms should still receive the COVID-19 vaccine. However, it may be best for you to get vaccinated against COVID-19 either before you start or after you finish taking certain MS medications. These may include:

  • Sphingosine 1-phosphate (S1P) receptor modulators: Gilenya (fingolimod), Mayzent (siponimod), Zeposia (ozanimod), and Ponvory (ponesimod)
  • Anti-CD20 monoclonal antibodies: Ocrevus (ocrelizumab), Kesimpta (ofatumumab), and Rituxan (rituximab)
  • High-dose steroids
  • Mavenclad (oral cladribine)
  • Lemtrada (alemtuzumab)

If you are taking or about to start taking an immunosuppressant for MS, talk to your healthcare provider. They can help you decide how to time your vaccine doses safely and effectively.

Effectiveness

The COVID-19 vaccine effectively protects people with MS from contracting SARS-CoV-2. The vaccine also lowers the risk of hospitalization for COVID-related complications.

Who Should Not Receive the COVID-19 Vaccine?

Talk to your healthcare provider before getting the COVID-19 vaccine if you:

However, some MS medications may reduce the effectiveness of the vaccine. One 2022 study found that people with MS who were taking disease-modifying drugs developed fewer antibodies to SARS-CoV-2 after being fully vaccinated. 

Similarly, in a 2021 study, only 3.8% of fully vaccinated MS patients contracted COVID-19. The majority of these patients were either undergoing anti-CD20 therapy or taking Gilenya (fingolimod), a sphingosine 1-phosphate receptor modulator.

However, the study also suggested that fully vaccinated patients with MS had a significantly reduced risk of ICU admission and death, regardless of what DMTs they were taking. 

According to the CDC, adults who are moderately or severely immunocompromised—whether by a disease, treatment, or medication—should get four doses of the COVID-19 vaccine. If your immune function is compromised by an MS medication, talk to your healthcare provider about getting an additional COVID-19 booster shot.

MS and COVID-19

MS is an autoimmune disorder, which means that it causes the immune system to attack its own healthy cells. It can also heighten the body’s natural inflammatory response. 

Autoimmune and inflammatory disorders like MS do not necessarily put you at a higher risk of getting COVID-19. However, some people with MS may have a greater chance of experiencing severe illness from COVID-10, including:

  • Older people
  • People with progressive MS
  • People with a higher degree of disability from MS
  • People with comorbid medical conditions, such as diabetes
  • People who take DMTs and other immunosuppressive MS medications

It’s especially important for people in these high-risk groups to receive the COVID-19 vaccine.

Why Is the COVID-19 Vaccine Important?

The COVID-19 vaccine offers effective protection against SARS-CoV-2 and related complications, such as severe illness and ICU admission. Research suggests that both the Pfizer-BioNTech and Moderna vaccines are over 94% effective.

Studies also indicate the COVID vaccine continues to protect you from hospitalization and death, even months after your last dose. 

Older and immunocompromised people—including some people with MS—have a higher risk of being hospitalized, becoming severely ill, or dying from COVID-19. Therefore, the CDC recommends that immunocompromised people receive an extra primary dose of either the Pfizer or Moderna vaccine and an updated bivalent booster.

Summary

Multiple sclerosis (MS) is an autoimmune disorder that causes damage to the nervous system, including the brain and/or spinal cord. The COVID-19 vaccine is a safe and effective way to protect yourself and others from COVID-19, as well as hospitalization, severe illness, and death.

Because certain vaccines may lead to MS flare-ups or relapses, some people with MS are unsure about whether they should get vaccinated against COVID-19.

According to the CDC and the National Multiple Sclerosis Society, most people with MS should be fully vaccinated with the COVID-19 vaccines made by Pfizer-BioNTech, Moderna, or Novavax, including any recommended booster doses.

Research suggests that most people with MS experience only mild side effects from the COVID-19 vaccine. People who take disease-modifying therapies (DMTs) to control their MS symptoms should talk to their healthcare provider about timing their vaccine doses correctly.

A Word From Verywell

If you have MS and are worried about getting the COVID-19 vaccine, talk to your healthcare provider. They can help you decide whether you should get the vaccine, how to prepare for possible side effects, and how to time your doses in a way that works best for you.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

Frequently Asked Questions

  • Are people with MS at a higher risk of getting COVID-19?
  • In general, people with MS do not have a higher risk of getting COVID-19. However, people with MS who are older, take disease-modifying therapies (DMT), and/or are in the Black or Hispanic/Latino communities may have an increased chance of COVID-19 complications, including hospitalization and intubation.Pregnant people with MS, people with comorbid health conditions, people with progressive MS, and people who are significantly disabled by MS are also in high-risk groups. It is especially important for people in these groups to get vaccinated.
  • Who needs to get the COVID-19 vaccine?
  • According to the CDC, everyone ages 6 months and older should get the COVID-19 vaccine. The National Multiple Sclerosis Society recommends that people with multiple sclerosis receive the COVID-19 vaccine, especially if they are in a high-risk group.
  • Is the COVID-19 vaccine safe?
  • The COVID-19 vaccine is safe and effective for most people. It can help to prevent you from contracting SARS-CoV-2, and it reduces your risk of related complications, such as severe illness, hospitalization, intubation, intensive care unit (ICU) admission, and death.Most of the reported side effects from the COVID-19 vaccine, such as muscle pain and fatigue, are mild and go away on their own. Serious side effects from the COVID vaccine (such as a severe allergic reaction) are extremely rare.

In general, people with MS do not have a higher risk of getting COVID-19. However, people with MS who are older, take disease-modifying therapies (DMT), and/or are in the Black or Hispanic/Latino communities may have an increased chance of COVID-19 complications, including hospitalization and intubation.

According to the CDC, everyone ages 6 months and older should get the COVID-19 vaccine. The National Multiple Sclerosis Society recommends that people with multiple sclerosis receive the COVID-19 vaccine, especially if they are in a high-risk group.

The COVID-19 vaccine is safe and effective for most people. It can help to prevent you from contracting SARS-CoV-2, and it reduces your risk of related complications, such as severe illness, hospitalization, intubation, intensive care unit (ICU) admission, and death.