#MSCOVID19: get vaccinated

Barts-MS rose-tinted-odometer: ★ (Blue Thursday #000080)

Where are all the new MS patients gone? We have national data showing that there has been a 30% fall in the number of new patients with MS starting on disease-modifying therapies (DMTs) during the COVID-19 pandemic. Where are these patients? I suspect due to the reconfiguration of the NHS because of COVID-19 many of these patients have yet to find their way through the diagnostic pathway. 

Many patients may have had neurological symptoms suggestive of a demyelinating syndrome and decided against seeking medical attention during the crisis. As these symptoms may have remitted they have now gotten on with their lives. Others are waiting for MRI scans, lumbar punctures and evoked potentials. 

We were hoping our Barts-MS service would get back to some form of new normal, but this is unlikely to happen for some time. A big concern is a recent increase in COVID-19 cases as a result of the Delta or Indian variant of SARS-CoV-2. More worrying is the low rate of vaccine uptake in our local area due to vaccine hesitancy

As you can see from the latest Government figures infections rates in Whitechapel are surging well above the national average and the vaccine data figures are very worrying; the majority of adults in Whitechapel have not been vaccinated and more importantly, less than a quarter (24.3%) have not had two doses compared to close to 60% nationally. At the Royal London Hospital, we are therefore bracing ourselves for a third/fourth wave of admissions. This will have knock-on effects and affect routine hospital services such as our Barts-MS service. The best thing you can do as an individual is to #GetVaccinatedASAP to prevent hospital admissions and deaths and to allow the NHS to get routine services back to normal. 

I have little doubt based on the principle that ‘time is brain’ that many people yet to be diagnosed with MS will do worse because of the inevitable delays in the management of their MS.

Conflicts of Interest

Preventive Neurology




General Disclaimer: Please note that the opinions expressed here are those of Professor Giovannoni and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust and are not meant to be interpreted as personal clinical advice. 

30 thoughts on “#MSCOVID19: get vaccinated”

  1. This is shocking. Don’t you think it is time the government made it compulsory to be vaccinated? Don’t these people know how irresponsible their behaviour is?

    1. Yes, it is shocking. I am not sure the Government should make it compulsory. We should learn from Israel. As soon as the Israelis made vaccine passports mandatory vaccination rates shot up. Why? If Israelis’ chose not to get vaccinated they couldn’t get a vaccine passport and hence they couldn’t participate in wider society, i.e. go to the shops, bars, schools, Univesity, restaurant, etc. In other words, if you decide not to get vaccinated you essentially become a social pariah. The Government should also make sure that people who can’t have a vaccine for medical reasons get an exception and a passport as well.

    2. Liberalism is fine, i.e. the freedom to choose provided your choice doesn’t impact others; vaccine hesitancy really tests this central tenet of liberalism.

      1. In many European countries, there are examples of mandatory vaccination (e.g. polio), or mandatory for a wide array of professionals (e.g. medical sector, or even all businesses that employ over 10 people).
        It has even been argued that it is part of the duty of the employer to provide for a safe working environment to demand that his employees are vaccinated against covid.
        So yes, liberalism, but there are other ways of adressing the problem.

  2. Sorry but my body my choice, forced experimental drug administration, for a virus that has a death rate of less than 0.028% is ludicrous, the vaccines don’t stop you getting it, passing it on and dining from it, so is taking it also ‘irresponsible’? Josef Mengele come back all is forgiven.

    1. Your body your choice…fine, but what are your arguments? Is it fear?. But you need to base your arguments on truth. The vaccines dont stop you getting it is false. It was shown that family members of people who were vaccinated did catch COVID. It does not stop you passing it on…false…Not tking it is irresponsible from a Societal perspective..

    2. Research and evidence has shown that it does stop you getting the virus compared to if you didn’t have the vaccine and it definitely prevents you from getting a severe version of it. Yes, it is your body your choice but that choice is affecting others. In January they were cancelling Cancer surgeries because of the level of covid cases and hospital admissions. Vaccinations are there to prevent this but it will not work unless the uptake is high.

    3. That is fine but then you should be barred from entering any space where you come into contact with other people, i.e. the vaccine refuseniks should be treated as modern-day lepers in case they are carrying and shedding SARS-CoV-2.

      This is why vaccine passports work; it is a choice of being part of society are being excluded from it. That is the kind of choice you need to make.

    4. And think, just who are you shilling for by repeating nonsense such as this? You are being duped and used by grifters my friend, who are set to benefit financially by the spread of this grade A, industrial strength guff. MD’s bete noir Andrew Wakefield for one.
      Follow the money.

    5. “for a virus that has a death rate of less than 0.028% is ludicrous”

      “Joshua Garza had a chance to get vaccinated against COVID-19 in January but he passed it up, thinking he didn’t really need it.
      Now, the 43-year-old Texan is hoping to inspire others to get the shot after he became so ill following his COVID-19 diagnosis that he needed a rare double lung transplant to survive.”


    6. One in ten get long COVID. I know a young, healthy person who got that. It is not funny. At all.

  3. Highlight the truth; majority of people residing in this area are of Bangladeshi origin. Bangladeshis have chosen not to take the COVID-19 vaccine because they are a minority community who have suffered adversely as a result of NHS intervention with their health care. The Bangladeshi community is understandably very suspicious of institutional interference with their daily operations.

    In truth, pretty much all British institutions are highly racist and have failed minority community in this country. What we are saying is wholesale opposition from Bame communities who are now reacting greatly adversely to cajoling from superstructure advice.

    Poverty, privation, lack of education, ghettoisation, and familiarity with language, and general understanding of the host community, has resulted in what is regarded as a great British mess of the situation in which exponential levels of death are occurring.

    We are all to blame for this.

    1. Yes and no. I live in Lambeth and we are not far off Whitechapel.

      Rate per 100,000 people: 147.3
      1st-dose = 50.3%
      2nd-dose = 30.4%

      However, Lambeth is not too dissimilar in terms of ethnic minorities; instead of Bangladeshi origin a lot of the population are from West African and Afro-Caribbean descent.

  4. As a wheelchair user with MS so so falling into the clinically extremely vulnerable category how concerned should I be by about for example going to hospital for an out-patient procedure if I have had both Pfizer vaccinations?

    1. Vaccines work. Provided you are not on an anti-CD20 therapy or S1P modulator you are likely to be protected. However, these vaccines are not 100% effective and there is a small number of people who get second infections.

      1. “provided you are not on anti-CD20 therapy”
        So the likes of Ocrevus etc. So what are those people supposed to do?
        We keep getting told 2/3 of such don’t mount much of an immune response(if any) to the vaccine, yet how are we supposed to know?
        Should neuros/nurses be calling people and telling them to get an antibody test.

        Perhaps they should just go back into hiding, it seems the professionals don’t really give a hoot.

      2. I agree Ali. A real failure of guidance and, frankly, compassion. Furthermore, news reports discuss variants of concern such as Delta, and how those unvaccinated (and partially) must remain vigilant. Apart from this blog there is not frequent enough mention of the millions of people immune compromised that (apparently) cannot mount an effective protective response to the vaccines.

      3. Many thanks for the reply.
        Why can’t those most vulnerable get an antibody test to see how protected they are?

      4. We are offering this to all people at Barts, our plans to go National were stiffled…

      5. Hi MD I am under st. Bart’s so how do I get this antibodies test and would my carer be able to get this?

      6. You say that the vaccine works but while the number of deaths are still low the percentage of those who died who had in fact had two vaccinations is very high at 36% which does not look as though it works that well!

        BBC News – UK Covid infections rise as Delta variant dominateshttps://www.bbc.co.uk/news/health-57525891

  5. Just had my 2nd dose of AstraZeneca; had a hard time with side effects after my 1st dose, also due to my Uhthoff’s, but no side effects at all after 2nd, not even a sore arm this time. Can’t understand why people wouldn’t want the vaccine. I look forward to being reunited with loved ones and a much reduced fear of this awful virus. The injection itself is nothing, I’ve had worse midgie bites.

  6. And now a preprint is out and getting a lot of attention stating that even mild covid causes brain tissue loss hence loss of smell, taste and memory problems.
    Frightening prospects, and a further plea for everyone to get vaccinated (two doses). Both for their sake and their communities. In addition, remember that circulating virus results in dangerous mutations.

  7. What are your thoughts on the recent biodistribution study coming out of Japan and also the changing opinion from CDC both in Mid 2020 and early 2021 to change the cycle threshold in PCR Tests therefore increasing “false positive cases in 2020” and then reversing that phenomenon in 2021 (perhaps to imply a decrease due to the vaccine instead of the decrease in CT)? Also, you consider the Univ of Illinois study going on as well. Lastly, take into consideration the vaccine isn’t be studied to demonstrate lowered transmissibility but rather lowering severe symptoms.
    In light of these studies, does this change your opinion of whether or not the vaccine is a “must have”?

  8. When I used to work on A&E, I was quite surprised by the fact that number of cases attendance is a factor of the street trafic. When streets are busy, A&E is busy, and when streets. This contradicts my understanding to medical emergencies as it should follow a different pattern.https://www.statista.com/statistics/823157/accident-and-emergency-attendances-england/

    I learned from this that healthcare provision is in a fluid state, and whatever poses a resistance in the pathway, makes the outflow lower.

    SAH, stroke and MI all had lower incidence during COVID.https://svn.bmj.com/content/early/2021/03/25/svn-2020-000695?utm_source=bmjcompany&utm_medium=landingpage&utm_campaign=Resourcesonstroke

    My guess about MS here is that it is similarly a “macro-scale” affection, with numerous minor forces rather than a single direct causation.

  9. Will a dose of Anti-CD20 (rituximab) have any effect if antibodies / immunity has already developed?

    This infusion will be after a smooth recovery from a mild case of Covid, followed by both doses of the Astra-Zeneca vaccine.
    The SARS-COV-2 IgG antibody level is 590.70 AU/mL

    1. If antibodies have developed they should remain based on work in monkeys (done over a decade) however they could drop.

      The antibody levels are meaningless without knowing what the test is

      COVID + vaccine = 2 x vaccine

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