The National Multiple Sclerosis Society
From The MS Information Sourcebook, produced by the National MS Society.
Many people with MS have concerns about the safety of routine vaccinations. Information is now available from a variety of sources that most vaccines are safe for people with MS.
The study evaluated data on vaccinations and other risk factors from medical records and telephone interviews with 440 people with multiple sclerosis or optic neuritis and 950 control subjects without neurologic disease.
An IOM-appointed committee of experts examined the relationship between hepatitis B vaccine and diseases of the nervous system such as multiple sclerosis. The committee evaluated an extensive collection of published, peer-reviewed scientific and medical literature related to the association of these diseases with the vaccine. This independent study by the Institute of Medicine confirms previous findings of no link between vaccinations against hepatitis B and the onset or worsening of multiple sclerosis.
The CDC also encourages the flu shot for any person who wants to reduce their chances of catching influenza.
The following vaccines have been evaluated in people with MS:
Other vaccinations such as pneumococcus vaccination and hepatitis A vaccination do not have published studies addressing their safety. Nevertheless, the clinical practice guideline recommends that people with MS who meet the CDC criteria for these vaccinations should be given them. CDC criteria can be viewed at http://www.cdc.gov/ncidod/guidelines/guidelines_topic_vaccination.htm
Who should not be vaccinated?Specific Recommendations Concerning the Smallpox Vaccine
Your doctor will know the general contraindications for each vaccine. For example, people with allergies to eggs may not receive the flu vaccine. However, people with MS have specific considerations:
People who are experiencing a serious relapse that affects their ability to carry out activities of daily living should defer vaccination until 4-6 weeks after the onset of relapse. People who have received immune globulin preparation in the past three months should not receive live attenuated virus vaccinations, such as varicella or MMR (measles, mumps, rubella). Live attenuated vaccines are those whose biological activity has been reduced so that their ability to cause disease has been weakened but not totally inactivated. People on therapies that suppress the immune system (immunosuppressants), such as mitoxantrone, azathioprine, methotrexate, cyclophosphamide and/or chronic corticosteroid therapy should not receive live, attenuated vaccines. A person with a suppressed immune system would be at greater risk for developing the disease. Note: Interferon medications and glatiramer acetate are not immunosuppressants; people who are taking any of these medications can be given all of the vaccines mentioned above.
The smallpox vaccine has never been studied in people with MS, and concerns
about smallpox in the U.S. developed after the Clinical Practice Guideline
was completed. This vaccine, however, is used to prevent a serious, generally
fatal illness, and should be made available to any person with MS who is
exposed to smallpox because the risks associated with not getting vaccinated
would be too great. Because of the serious adverse events that can occur
with this vaccine, however, it is the recommendation of the Society's Chief
Medical Officer that no person with MS be given it unless he or she has
been directly exposed to smallpox.
Copyright © 2003, The National Multiple Sclerosis Society