Summarizing the above.
GETTING ACCESS TO MEDDRA WITHIN OMOP VOCABULARIES
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You need to contact the MSSO and ask for a license.
https://www.meddra.org/about-meddra/organisation/msso -
Once you receive a license, go to Athena and request your Vocabularies along with MedDRA. The Vocabulary team will get a notification and you will be contacted requesting a proof of license.
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Once your account knows it is allowed to download MedDRA, you would re-request the OMOP Vocabulary (with MedDRA included).