COVID-19 Vaccination Intent and Uptake in People with MS: A Longitudinal Survey Study

Background: People with multiple sclerosis (pMS) are at higher risk of severe COVID-19 due to neurologic disability and immunosuppressive medications. Vaccination is key to protect pMS from severe COVID-19.

Objectives: The CopeMS study led by The University of Texas at Austin and the MS Association of America investigates the long-term impact of the COVID-19 pandemic on pMS.

Methods: We investigated vaccination intent, uptake, and attitudes regarding vaccination in the MS community based on findings from a national US survey of pMS conducted monthly between December 2020 and September 2021. Kaplan-Meier estimates were used to assess vaccination uptake and compare subgroups based on MS phenotype, age, race and ethnicity, and disease-modifying therapy (DMT) utilization.

Results: 164/529 CopeMS participants completed the survey monthly and were included in this subanalysis. The cohort was comprised of 117 people with relapsing MS (71%), 43 progressive MS (26%), and 4 type unknown. One hundred and two (62%) participants were 55 and older. One hundred forty-nine (91%) participants self-identified as White, and 9% as Non-White or preferred not to disclose. At baseline, which was immediately prior to COVID-19 vaccine approval by the FDA, 44.5% of respondents reported that they would get vaccinated as soon as vaccines became available, 31.1% stated they would likely get vaccinated but needed more information, 15.2% responded that they may vaccinate in the future, and 9.2% that they were not planning to get vaccinated. Vaccination hesitancy was higher in pMS who were also not planning to get the Flu shot (20.1% of our cohort), with 33.3% responding no and 33.3% maybe to the COVID-19 vaccine at baseline. By the end of the survey period, 90% of the cohort had been vaccinated against COVID-19. Kaplan-Meier estimates of time-to-reported vaccination showed no differences in vaccination uptake across MS phenotypes (RRMS vs PMS), race and ethnicity (White vs non-White), or age (<55 vs 55+). pMS on DMT had significantly shorter time-to reported vaccination than those off DMT (Logrank test, p=0.02). Of 15 pMS who initially stated they would not get vaccinated, 6 (40%) ended up getting the COVID-19 vaccine during the study period.

Conclusions: Our findings suggest that COVID-19 vaccination uptake was high in pMS, with slower uptake in pMS not treated with DMTs. Our study highlights that there may be opportunities to reduce vaccination hesitancy in pMS.