Today I am starting a difficult experiment. An informal clinical trial with a single subject: Myself. I have MS and am treated successfully with Ocrelizumab. Unfortunately, the action of Ocrelizumab is to kill B cells, which are the cells that make antibody. /2

The production of antibody is the main mechanism by which all COVID-19 vaccines operate. It is known that being treated with Ocrelizumab heavily suppresses responses to vaccines. /3

This suppression lasts 6 months, and which time, the B cells start to repopulate again - gradually. Today, I was due my next dose of Ocrelizumab. After a lot of discussion, and widespread access to relevant data, including some unpublished, I have decided not to take this dose./4

This, of course, puts me at a greater risk of a relapse of MS. My most recent relapses were horrifying - affecting my sense of taste, vision, and mobility. Nevertheless, the best advice suggests that the risk of COVID infection is the greater of the two. /5

The aim is to repopulate B cells for up to three months, get vaccinated with the best vaccine available to me, allow up to three months to produce antibodies, and then restart Ocrelizumab therapy within 6 months. /6

I am not alone in making these sorts of decisions. Every person who is on immunosuppressive treatment, which includes many on anti-cancer treatments, need to balance these risks and benefits - of vaccination and effective treatment. /7

What is critically needed is for the vaccine supply to not be a political football. We need clinicians to be able to administer the vaccine at the optimum point in the manipulation of the chemotherapy regime. At this time, clinicians appear to have no control at all over this./8

The vaccination of 24 million people is far from trivial. World wide this is the largest and fastest planned health intervention in human history. I really hope we are up to it.