Multiple Sclerosis Centers of Excellence
Vaccines and Multiple Sclerosis: A Practical Guide
Vaccines protect you from serious illness without your having to get sick first. If you have multiple sclerosis (MS), you may wonder whether vaccines are safe for you. The short answer is yes. Experts at the American Academy of Neurology reviewed the research and found that people with MS should get vaccines on the same schedule as everyone else. The main thing to plan around is your MS medicine.
Will a Vaccine Cause MS or Make It Worse?
This worries a lot of people, so it is worth saying plainly. Research has not found that vaccines cause MS. Research has also not found that vaccines bring on a relapse. If you are in the middle of a relapse right now, it is reasonable to wait until it passes before getting a shot. That is partly because the steroids used to treat a relapse can make a vaccine work less well.
Time Your Vaccines Around Your MS Treatment
Try to be up to date before you start a disease-modifying therapy. Some MS medicines calm the immune system, which can make a vaccine less effective and can make certain infections more likely. Your provider may check whether you are already immune to something, such as chickenpox, and have you finish any needed shots first. Plan for about a month between the vaccine and the start of your medicine so it has time to work.
Always tell your provider or pharmacist which MS medicine you take before you get any vaccine. The timing advice differs from drug to drug.
Live and Non-live Vaccines
Vaccines are made in different ways. Some use a weakened live virus. Others use killed virus, inactivated toxins, or just a piece of the germ. The difference matters in MS, because live vaccines can be a problem if your MS medicine suppresses your immune system. Most routine adult vaccines are not live.
The Flu Shot
Unless there is a specific reason not to, get a flu shot every year. Flu is common and can be serious, and the injected vaccine has been well studied in people on MS treatment.
The nasal spray version is a live vaccine, so if your MS medicine suppresses your immune system, choose the shot instead. If someone in your household gets the nasal spray, you do not need to avoid them. Any virus they shed is in respiratory secretions, and passing it to someone else is very rare.
Other Vaccines To Ask About
Shingles. This vaccine is not live and is safe with MS medicines. It is given as two shots and prevents a painful rash that people with MS may be more likely to get.
Chickenpox. If you have never had chickenpox or the vaccine, and you may start certain MS drugs, you will likely need this one first.
COVID-19. COVID-19 vaccines and boosters are safe and effective for people with MS, and they are not live vaccines. Follow the current guidance for your age and health history.
Pneumococcal and HPV. Both are recommended for many adults, and the schedules depend on your age and history. Ask your provider what applies to you.
When to Talk to Your Provider
Talk with your VA provider or pharmacist about which vaccines you need and when to get them, especially before you start or switch an MS treatment. Bring a list of your medicines. Keeping your vaccines current is one of the simplest ways to protect your health.
Based on an article by Kathy Tortorice, PharmD, BCPS.
