COVID‑19 vaccination remains an important way to reduce the risk of severe illness, hospitalisation and death from COVID‑19. This guidance has been developed by a group of Australian and New Zealand neurologists with a special interest in multiple sclerosis (MS), through the Australian and New Zealand Association of Neurologists (ANZAN), in collaboration with MS Australia. It aims to address common questions about COVID‑19 vaccination for people living with MS.
With over 10 billion vaccines administered worldwide, vaccination remains one of the most effective ways to reduce the risk of severe COVID‑19. The risk of severe COVID‑19 is higher for some people, including older adults, those with chronic medical conditions such as heart, lung disease or diabetes, people who are immunocompromised, and certain population groups who experience higher rates of severe illness.
Evidence shows that having MS does not increase the likelihood of developing COVID‑19 or experiencing severe complications. However, some factors – including age, level of disability, other medical conditions, and certain MS disease‑modifying therapies (DMTs) – can influence the risk of severe COVID‑19 and how well a person responds to vaccination.
This information is intended to support people with MS to understand current COVID‑19 vaccination recommendations and how these may apply in the context of MS treatments. Your MS healthcare team and neurologist remain your primary advisers for individual decisions regarding your DMT, other medications, and the timing of vaccination.
The current recommendation in Australia is that all people aged 18 years and over receive a primary course of COVID-19 vaccination.
COVID-19 vaccines used in Australia include ‘Comirnaty’ (Pfizer – BioNTech) formulations. For most people in the general population, the primary vaccine course consists of a single dose. For people who are severely immunocompromised, the primary vaccine course consists of two (2) doses, with a third (3) dose considered in some circumstances, usually at least eight (8) weeks apart.
Booster doses may be recommended periodically according to age and individual risk factors. Information on approved COVID-19 vaccines and current recommendations in Australia can be found here.
It is important to understand the difference between a primary course of vaccination and a booster dose.
The primary course of vaccination consists of the minimum number of doses to achieve the desired immune response.
For most people aged 18 years and older in the general population, the primary course currently consists of one dose of a COVID-19 vaccine.
For people who are severely immunocompromised, additional doses are required as part of the primary course to improve protection. Depending on age and clinical circumstances, this may involve two (2) primary doses, with a third (3) dose considered. Children and adolescents aged 6 months to 17 years only require additional primary doses if they are severely immunocompromised or have specific high‑risk medical conditions. Further details are provided in the vaccination tables on this page.
A booster dose is administered after completion of the primary course of vaccination, to remind the body how to fight the virus. In Australia, booster doses are generally recommended every 12 months, with 6‑monthly boosters recommended or considered for people at higher risk of severe COVID‑19, including those with severe immunocompromise, depending on age and individual risk factors. Further details are provided in the vaccination tables on this page.
For most people with MS, COVID-19 vaccination follows the same national recommendations as the general Australian population. However, some people with MS may be considered severely immunocompromised because of medications they receive to treat their MS.
This currently includes people receiving:
People who are severely immunocompromised are recommended to receive a two-dose primary course and may require additional doses with booster timing based on age and individual risk factors. Further details are provided in the vaccination tables on this page.
The bottom line is that COVID‑19 vaccination is recommended for all people with MS; however, vaccine response varies by DMT class and timing, and vaccination schedules may differ for those who are severely immunocompromised.
Information about vaccination schedules has been provided by the Department of Health, Disability and Aged Care and can be viewed here.
It is currently recommended that everyone aged 18 years and over receive COVID‑19 vaccination, with vaccination considered for those under 18 years if they have risk factors for severe disease or are severely immunocompromised.
Studies have shown that there is no evidence that people with MS are at greater risk of adverse events following COVID‑19 vaccination. The risks associated with COVID‑19 are particularly significant for people with MS who have higher levels of disability and generally outweigh any potential risks from vaccination. As a person with MS, COVID‑19 vaccination is strongly recommended.
Evidence shows that this is not the case. All COVID-19 vaccines can produce side effects that include fever and chills, headache, muscle pain and fatigue.
Fever can, on rare occasions, cause a temporary re-emergence of previous MS symptoms (a so-called “pseudo-relapse”). Evidence suggests that this only lasts while the fever is present – typically less than 24 hours with these vaccines – and does not indicate any new inflammation or damage to the brain and spinal cord.
Similarly, vaccine-related fatigue may temporarily worsen MS-related fatigue, but this should also be temporary.
In most cases, you should receive your COVID‑19 vaccination when it is offered to you. However, there are specific considerations for some DMTs.
These include ocrelizumab (Ocrevus®), ofatumumab (Kesimpta®), ublituximab (Briumvi®), alemtuzumab (Lemtrada®), fingolimod, siponimod (Mayzent®), ozanimod (Zeposia®), cladribine (Mavenclad®) and rituximab.
If you are being considered for autologous haematopoietic stem cell transplantation (AHSCT) or CAR T‑cell therapy, your MS healthcare team and neurologist will be able to advise on the most appropriate vaccination timing based on your individual circumstances and treatment history.
It is not recommended that you stop or delay your MS therapy around the time of COVID-19 vaccination unless advised by your neurologist. The risks to your long-term health from a recurrence of MS disease activity after stopping treatment are far greater than any potential risks associated with vaccination.
For people on intermittent therapies, or those who are about to start a new therapy, there may be some opportunity to better coordinate the timing treatment and vaccination. Any changes to treatment timing should only be made in consultation with your neurologist, to ensure that the risks of delaying therapy are minimal and appropriately managed.
You should advise the person administering the COVID-19 vaccine if you have ever had an allergic reaction to a previous dose of a COVID‑19 vaccine or to any other vaccination. Some vaccines contain additional components that can cause reactions in some people. The healthcare professional administering the vaccine will be able to assess your situation and advise whether it is safe to proceed with the vaccine being offered.
For more information on COVID-19 and MS, please click here.
Last updated: 25/03/2026
Last reviewed: 25/03/2026
