Vaccine hesitancy among people with multiple sclerosis

Area of Science:

• Neurology
• Immunology
• Public Health

Background:

• The COVID-19 pandemic highlighted vaccine hesitancy, particularly among people with multiple sclerosis (pwMS).
• PwMS face increased risks from vaccine-preventable diseases like influenza, pneumococcal disease, and HPV-related cancers.
• Lack of standard measles, mumps, and rubella (MMR) immunity screening is concerning given recent outbreaks.

Purpose of the Study:

• To assess the vaccination status of pwMS.
• To identify reasons for vaccine hesitancy in this population.
• To inform improved vaccination strategies for pwMS.

Main Methods:

• A prospective audit was conducted at an Irish tertiary referral MS center.
• A questionnaire assessed awareness, uptake, and hesitancy for influenza, pneumococcal, SARS-CoV-2, HPV, and MMR vaccines.
• Clinicians administered the questionnaire during outpatient MS clinic visits.

Main Results:

• SARS-CoV-2 vaccine willingness was high (90.5%) among pwMS, exceeding rates in other Western countries.
• Influenza and pneumococcal vaccine uptake were around 80%, limited by perceived unnecessity and unfamiliarity.
• Primary SARS-CoV-2 hesitancy stemmed from safety concerns; influenza vaccine uptake increased significantly with healthcare professional recommendation (OR 8.1).
• Pneumococcal vaccination was notably low in patients on B-cell therapies (91.7% never received).
• HPV (1.0%) and MMR (51.4%) vaccine uptake were suboptimal.
• Healthcare professional promotion of influenza and pneumococcal vaccines was low (4.8-32.4% and 0-18.1%, respectively).

Conclusions:

• Vaccine hesitancy affects 10-20% of pwMS, driven by insufficient knowledge and misconceptions.
• Suboptimal vaccine promotion by healthcare professionals managing pwMS contributes to hesitancy.
• Context-specific vaccination counseling is essential for pwMS to prevent infection-associated disability and treatment complications.