b'testing of these individuals should be considered,and revaccination be available for those withnegative or possible low antibody results. Iam attaching a copy of the NMSS article aswell as the most recent CDC guidelinesapplicable to this topic. Thanks in advance forany help or guidance you may provide to us.Michael G. SheppoGettysburg, Pa.Dr. Thrower responds:The issue of how B cell therapies such asDear MS Focus: Ocrevus might aect the antibody responseMy wife Karen received her rst dose of to COVID vaccines is a complicated one.COVID-19 (Moderna) vaccine on Jan 29. She There really is no research to dene an idealthen had an Ocrevus infusion on Feb 15 time for when the COVID vaccine should befollowed by her second COVID vaccine on given relative to the infusion. Myself andMarch 10. This was done following the guide- others would argue that patients who arelines in place at that time. I was concerned that established on Ocrevus have a stable immunethe Ocrevus infusion might aect antibody status, meaning their B cells are depletedproduction and asked to have her blood throughout their six-month course. Therefore,tested for Immunoglobin G (IgG). Our primary the timing of vaccination may not be of muchcarephysicianwasabletondatestfor consequence. total SARS-CoV-2 antibodies at Quest labs. Now the good news. Our immune systemHer blood was drawn on March 29, and her is more than just B cells and antibodies. Theresultscamebacknegativeforantibodies other major component of our immune(0.4 U/ml based on 0.8 Neg, 0.8 Pos). My response is through T cells, which, in theory,blood was also tested and resulted in positive are unaected by Ocrevus. Just recently a testresults, 379.7U/ml. Our physician recommended was developed to look for the T cell responsethat Karen continue to protect herself as if to COVID-19. Data presented at the Academyshe had not been vaccinated. Based on an of Neurology recently conrmed that this Tarticle from the National Multiple Sclerosis cell response to vaccination is indeed intactSociety website on March 30 titled Anti-CD20 in the vast majority of MS patients on B cellmonoclonal infusions (Ocrevus and Rituxan therapies. So, while your wife may not haveand biosimilars), I believe Karen should be made antibodies to the vaccine, she likely stillrevaccinated after a period of at least 12 weeks has some immunity because of her T cellfrom her Ocrevus infusion. response.I am concerned that other MS patients Dear Jane at MS Focus: who have taken Ocrevus or similar drugs andhavebeenvaccinatedforCOVID-19may Thank you for the help MS Focus providedwrongly believe that they are protected when for me to get hand controls on my car. I reallythey may not be. I also believe that antibody hit the ground running: the day after I got themsfocusmagazine.org 10'