Evolution of our understanding of MS-COVID-19 interactions and concerns for vaccination.

• Immunomodulators like anti-CD-20 Monoclonal antibodies targets T and B lymphocytes and potent proinflammatory cell lines. • Timing of the COVID-19 vaccines is a consideration with DMT. • Timing MS Medications with COVID-19 mRNA Vaccine. As the news of approval of COVID-19 vaccination emerge, neurologists across the globe ponder upon whether to use immunotherapies in patients with Multiple Sclerosis (MS). This paper highlights the mechanism of various disease modifying therapies (DMTs) as well as the recently approved Pfizer and Moderna vaccines for COVID-19 as well as guidelines as introduced by National Multiple Sclerosis Society. As their mechanisms counteract each other at the molecular level, we believe further evidence and data might lay the foundation to formulate much needed recommendations for the usage of these medications while vaccinating MS patients on DMTs. [ABSTRACT FROM AUTHOR]