@CineMike 

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CineMike

Need help figuring this out ...

I have a question that is not specific to the COVID vaccine but any vaccination in general. From my understanding, both Ocrevus and Kesimpta have different methods, doses and schedules but the result is the same with the depletion of B cells. Presumably this means that for both drugs it would take 5 to 8 months, give or take, for B cells to start to return. So for Ocrevus, having infusions every six months does offer a small window for vaccinations where there's some B cell activity around month 5, right before the next infusion right? For Kesimpta though, that same window doesn't exist because you keep injecting every month. It seems like this might be a bit of a drawback for Kesimpta because I'm not sure how you can benefit much at all from vaccines with that schedule. Why is it necessary to inject Kesimpta every month? Once the B cells are depleted then they take months to return. I ask all of this because I'm trying to decide which DMT I want to go with. I was leaning towards Kesimpta but not having that little window for some B cells to return so that you can build some antibody response to vaccines concerns me. I mean, especially for the COVID booster shots that will come out some time. Ugh I wish that I could just go with a safer, less aggressive treatment like Copaxone but every where I look everyone says to go with the big guns. Yeah I know people hate the needles and skin reaction but I just am having trouble with idea of seriously compromising my immune system. I'm still totally asymptomatic, for which I know that I'm lucky but it makes the big guns approach harder to accept. I would love any guidance in this area because this very new and scary at the moment. My head is spinning trying to decide. Thank you in advance to anyone who offers their support!
@fay_mishima

Hi @CineMike what type of MS do you have?

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@CineMike

@fay_mishima Well I think that I'm still technically RIS because I still don't have symptoms. When they first found the inactive lesions, my doctor said that she thought monitoring was all that was needed. Now in the follow up MRI there was a new lesion and now she thinks I should start a DMT. I'm being told that indicates progression and starting a DMT as early in the process as possible will help my outcome. If any of these lesions have caused symptoms then they are so mild that I can't really identify them. I do have a familial tremor but I've had that for many years and stress can make it a little worse. I guess my vision has been getting worse over the last several years but both of my parents started wearing glasses at my age so that just seems like genetics. So I guess that I'm somewhere in between RIS and CIS?