A to Z of MS
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A to Z of MS Vaccination and immunisation
In the past there has been concern over the potential effect of vaccinations on people with multiple sclerosis. Research has failed to find evidence to support these concerns.
A study in France published in 2001 compared the relapse history of 643 people with MS with their vaccinations against tetanus, hepatitis B or influenza. The study found no evidence that vaccination increased the short-term risk of a relapse.
In 2011, Argentinian researchers found that the risk of developing MS remained unchanged after vaccinations for BCG, hepatitis B, influenza, MMR, polio and typhoid fever. Their results suggested that diphtheria and tetanus vaccination may be associated with a decreased risk of MS.
A separate study by the same team, which involved only seven people, found that the yellow fever vaccine significantly increased the relapse risk.
A study published in 2014 found no association between the hepatitis B or human papillomavirus (HPV) vaccines and an increased risk of multiple sclerosis up to three years after vaccination.
There are a few exceptionally rare complications of the vaccinations themselves but the risk of these occurring are the same for people with MS as in the general population. There is strong evidence for infections increasing the risk of a relapse.
The NICE Guideline states that there is no reason why people with MS should not have all the vaccinations that are required both for use in the UK and when travelling abroad. It is preferable to be protected than run the risk of contracting the diseases, many of which are serious and life threatening.
- People who are unwell eg experiencing a debilitating relapse may be advised to defer vaccination. This is because it will be difficult to tell the difference between the symptoms of the relapse or other illness and a bad reaction to the vaccine.
- People on therapies that suppress the immune system, such as mitoxantrone, azathioprine, methotrexate, cyclophosphamide or steroids should not receive 'live' vaccines as they may be at greater risk for developing the disease. Make sure that your doctor is aware of all the medications you are taking.
Confavreux C, et al.
Vaccinations and the risk of relapse in multiple sclerosis. Vaccines in Multiple Sclerosis Study Group.
New England Journal of Medicine 2001;344(5):319-326.
Rutschmann OT, et al.
Immunization and MS: a summary of published evidence and recommendations.
Buljevac D, et al.
Prospective study on the relationship between infections and multiple sclerosis exacerbations.
Farez MF, Correale J.
Immunizations and risk of multiple sclerosis: systematic review and meta-analysis.
Journal of Neurology 2011;258(7):1197-1206.
Farez MF, Correale J.
Yellow fever vaccination and increased relapse rate in travelers with multiple sclerosis.
Archives of Neurology 2011;68(10):1267-1271
Langer-Gould A, et al.
Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases.
JAMA Neurology 2014 Oct 20. [Epub ahead of print]