Vaccination coverage and its determinants in patients with multiple sclerosis-a multicenter cross-sectional study.

Area of Science:

• Neurology
• Immunology
• Public Health

Background:

• Multiple Sclerosis (MS) societies recommend complete vaccination for patients with MS (pwMS) to prevent infections, especially when using disease-modifying therapies (DMTs).
• Understanding vaccination coverage and its influencing factors in pwMS is crucial for managing infection risks.
• This study investigates vaccination rates in pwMS compared to healthy individuals, considering psychological and professional factors.

Purpose of the Study:

• To analyze vaccination coverage in pwMS versus healthy controls.
• To identify determinants of vaccination coverage, including hesitancy, MS-specific beliefs, trust in information sources, and the role of general practitioners (GPs).
• To assess the impact of DMTs on vaccination rates in pwMS.

Main Methods:

• A cross-sectional, multicenter observational study in six German MS centers.
• Vaccination coverage was assessed using a vaccination index (VI) based on eight standard vaccinations.
• Data were collected via questionnaires, vaccination card analysis, and GP surveys.

Main Results:

• Vaccination index (VI) was slightly lower in pwMS (n=397) than in healthy controls (n=300; p=0.057).
• Vaccination hesitancy was low and similar between groups; it explained only 10%-16% of VI variance.
• 82% of surveyed GPs expressed reluctance to vaccinate pwMS due to concerns about MS side effects or DMT interactions.

Conclusions:

• Vaccination coverage in pwMS is worryingly low, even for those on highly effective DMTs, and tends to be lower than in healthy controls.
• Intrinsic factors like vaccination hesitancy do not fully explain the low rates.
• Inconsistent vaccination recommendations from GPs, stemming from safety and DMT interaction concerns, likely contribute significantly to suboptimal vaccination coverage in pwMS.