Reader Response: Effect of Ocrelizumab on Vaccine Responses in Patients With Multiple Sclerosis: The VELOCE Study

I read the article by Bar-Or et al.1 with interest. I am curious why the authors chose to give Pneumovax 23 (PPSV23) first and then, for the OCR1 group, gave Prevnar (PCV13) 4 weeks after? This is not consistent with CDC recommendations. These recommendations state that for patients with iatrogenic immunosuppression—e.g., on ocrelizumab—PCV13 should be given first and then PPSV23 no sooner that 8 weeks later. However, in cases in which PPSV23 was given first, PCV13 should not be given sooner than 1 year later. The trial design in VELOCE to give PCV13 4 weeks after PPSV23 is not consistent with CDC recommendations and can be misinterpreted by readers as the correct order and timeframe in which to give these immunizations. See immunize.org/catg.d/p3075.pdf for further information.

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