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 for further information.

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