If you’re on a regular medication for MS or a related condition, then it’s recommended that you should continue to take this medication, especially in regard to disease modifying therapies (DMTs) because of the very real risk of relapse when ceasing DMTs.  Specific information related to each of the MS DMTs and treatments during the pandemic can be found below. It’s important that if you have any questions about the timing of your MS DMTs and vaccinations, that you discuss this with your neurologist or MS specialist healthcare team. Certain DMTs may need slight adjusting during this period, but most will continue as usual. The Australian and New Zealand Association of Neurologists (ANZAN)/MS Australia vaccination guidance discusses managing vaccinations and DMTs in more detail detail and can be found here. Self-injected therapies (glatiramer acetate [Copaxone], beta-interferon [Avonex, Betaferon, Plegridy, Rebif]) These medications are not immunosuppressive. You should continue these medications and follow the standard advice regarding prevention of COVID-19 infection. Intermittent immunotherapies (plasma exchange, intravenous gammaglobulin [IVIg]): These therapies have a minimal impact on immune function. You should continue these medications and follow the standard advice regarding prevention of COVID-19 infection. Regular potentially immunosuppressive MS therapies (natalizumab [Tysabri], fingolimod [Gilenya], siponimod [Mayzent], dimethyl fumarate [Tecfidera], teriflunomide [Aubagio]): These therapies are mildly immunosuppressive, there is currently no evidence that they increase the risk of COVID-19 infection. Specifically, studies of natalizumab, dimethyl fumarate and teriflunomide have not shown any cause for concern. Because of the very real risk of relapse on discontinuing these therapies compared to the currently low risk of COVID-19 infection, the present advice is that these medications should be continued. Your neurologist may wish to monitor your immune cell counts more frequently. You should follow the standard advice regarding prevention of COVID-19 infection. Immunosuppressive therapies (prednisolone, methotrexate [MTX], azathioprine [Imuran], mycophenolate mofetil [Cellcept], cyclophosphamide [Cytoxan]): The level of immunosuppression with these medications is variable and depends upon the dosage and combination of treatments. Because of the very real risk of relapse on discontinuing these therapies compared to the currently low risk of COVID-19 infection, the present advice is that these medications should be continued. Your neurologist may wish to monitor your immune cell counts more frequently. You should follow the standard advice regarding prevention of COVID-19 infection. Pulsed immunosuppressive therapies (rituximab [Rituxan], ocrelizumab [Ocrevus], alemtuzumab [Lemtrada], cladribine [Mavenclad], autologous haematopoietic stem cell therapy [AHSCT]) These therapies are immunosuppressive to varying degrees and for variable periods of time. Because of the pulsed nature of these therapies there are options to delay courses of treatment. Decisions on whether or not to delay a course of these therapies should be discussed with your neurologist. Because of the very low risk of COVID-19 in many states and territories, the use of alemtuzumab has resumed sometimes with additional precautions of self-isolation immediately before and after therapy. A study of cladribine hasn’t shown any cause for concern. The risk/benefit profile of rituximab and ocrelizumab in those with additional risk factors for worse outcomes from COVID-19 (age >60 years, male gender, comorbidities, higher levels of disability) needs to be considered carefully on a case-by-case basis. You should follow the standard advice regarding prevention of COVID-19 infection, in some situations, on the advice of your neurologist, it may be appropriate to take additional precautions.