Anyone who receives a vaccination has a very small risk of a neurological complication. Thus, the use of vaccines in patients with MS is a very important topic. The recognized causal effect between infections and MS flares is the primary concern when using vaccines in patients with MS.
According to Patricia K. Coyle, MD, professor in the Department of Neurology at Stony Brook University in New York, the neurologist must conscientiously think about what types of vaccinations the patient needs before starting any disease-modifying therapies. Ideally, patients with MS should not receive a live-virus vaccine. However, varicella zoster is routinely given to patients being started on fingolimod, and even though it is a live-attenuated vaccine, no major problems have been observed.
Overall, studies looking at injectable (inactivated) influenza vaccines, and, most recently, the HPV and Hepatitis B vaccines, in patients with MS demonstrated that receipt of these vaccinations is not linked with an increased risk of MS disease activity. (De Keyser J et al.J Neurol Sci. 1998;195:51-53.;Langer-Gould A et al. JAMA Neurology. 2014;71:1506-1513.)
Dr. Coyle stresses that when it comes to vaccinating patients with MS, “You are really looking at what is the value of the vaccination; and if the vaccination can prevent a very bad infection,” vaccination would be considered a good choice.