Vaccination in multiple sclerosis - Challenging practices (Review)
Carmen Adella Sirbu1,2, Anca Alexandra Florea2, Minerva Claudia Ghinescu1
1Department of Medical-Surgical and Prophylactical Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania.
Abstract:
Infections are an ever-present problem in the medical community, even more so for patients with multiple sclerosis (MS), for whom these infections have been linked to relapses and neurological disabilities. Even though it was believed that MS can be caused by an infection, research does not support this theory. MS is a chronic inflammatory disease considered to be autoimmune. Vaccination is proven to be one of the most effective means to prevent infections, but still it is surrounded by controversy in the general populations, as well as in the MS group. Vaccines are generally considered safe for MS patients. The exceptions from this, which turn into contraindications, are a medical history of allergic reactions to one of the vaccine components and immunosuppressed patients in the particular case of live vaccines. Given the presumed autoimmunity of the disease, some medication for MS is immunosuppressive and any live vaccine should be administered before starting treatment. Although there is still confusion regarding this subject, the current guidelines have clearer recommendations about vaccinations in MS patients and especially in treated MS patients.
Insights
Vaccinations are generally safe for multiple sclerosis (MS) patients, but live vaccines are contraindicated for those on immunosuppressive therapy or with allergies. Guidelines clarify vaccination recommendations for MS patients, especially those undergoing treatment.
Area of Science:
- Neurology
- Immunology
- Infectious Disease Prevention
Background:
- Infections pose risks for multiple sclerosis (MS) patients, potentially triggering relapses and neurological decline.
- While MS is considered an autoimmune inflammatory disease, the theory of infection as a cause is not supported by current research.
- Vaccination is a critical preventive measure against infections but faces public and patient hesitancy.
Purpose of the Study:
- To clarify vaccination recommendations for patients with multiple sclerosis (MS).
- To address concerns regarding vaccine safety and efficacy in the MS population.
- To provide guidance on timing of vaccinations, particularly live vaccines, in relation to MS treatments.
Main Methods:
- Review of current scientific literature and clinical guidelines on vaccinations in MS patients.
- Analysis of contraindications and precautions for vaccine administration in individuals with MS.
- Consideration of the impact of immunosuppressive therapies on vaccine recommendations.
Main Results:
- Vaccines are generally considered safe for the majority of MS patients.
- Contraindications include a history of allergic reactions to vaccine components and immunosuppression (especially for live vaccines).
- Live vaccines should ideally be administered before initiating immunosuppressive MS treatments.
Conclusions:
- Current guidelines offer clearer recommendations for vaccinating MS patients, including those on treatment.
- Adherence to guidelines ensures optimal infection prevention while minimizing risks associated with vaccinations in MS.
- Informed vaccination decisions are crucial for managing MS and preventing infection-related complications.
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