Multiple Sclerosis (MS) is a chronic neurological condition affecting the brain, spinal cord, and optic nerves, where the immune system mistakenly attacks the myelin sheath that protects nerve fibers. Vaccination is a particularly nuanced area for individuals with MS. Informed decisions require careful consideration of a person’s MS presentation, treatment regimen, and overall health. These decisions are best made in consultation with healthcare providers to ensure safety and effective protection.
Vaccines to Avoid
Live-attenuated vaccines should be avoided by individuals with MS, especially those undergoing immunosuppressive therapies. These vaccines contain a weakened, but still living, form of the virus or bacteria. Examples include the Measles, Mumps, and Rubella (MMR) vaccine, the Varicella (chickenpox) vaccine, and the Yellow Fever vaccine. The live attenuated influenza vaccine, typically administered as a nasal spray, is also not recommended.
Recommended Vaccines
Many vaccines are considered safe and recommended for people with MS, including those on disease-modifying therapies. These include inactivated vaccines, which contain killed viruses or bacteria, or subunit, toxoid, and mRNA vaccines, which use only parts of a pathogen or genetic material. Specific examples include the inactivated influenza vaccine (the injectable flu shot), which is recommended annually. Other safe vaccines include Tetanus, Diphtheria, and Pertussis (Tdap), Human Papillomavirus (HPV), Hepatitis B, and COVID-19 vaccines. The inactivated shingles vaccine (Shingrix) is also considered safe.
How Vaccine Types Interact with MS
Live-attenuated vaccines involve a weakened but still replicating form of the pathogen, which can trigger a robust immune response, including both antibody production and cellular immunity. While this strong response is beneficial for healthy individuals, in people with MS, particularly those on immunosuppressants, there is a theoretical concern that the weakened live virus could overstimulate the dysregulated immune system, potentially leading to an MS relapse or exacerbation of symptoms.
In contrast, non-live vaccines, such as inactivated, subunit, toxoid, and mRNA vaccines, do not contain live organisms. Inactivated vaccines use killed pathogens, while subunit and toxoid vaccines contain only specific proteins or toxins from the pathogen. mRNA vaccines deliver genetic instructions for the body’s cells to produce a specific viral protein, prompting an immune response without introducing the virus itself. These non-live vaccine types are safer for individuals with MS because they stimulate immunity without the risk associated with a replicating live pathogen, minimizing potential immune system overactivation.
Discussing Vaccination with Your Doctor
Consulting a healthcare professional, such as a neurologist or primary care physician, is always advised before receiving any vaccine with MS. Vaccine decisions are highly individualized, considering a person’s specific MS disease activity, current medications (particularly immunosuppressants), and overall health status. The timing of vaccinations relative to MS relapses or treatment cycles also warrants discussion with your doctor to optimize vaccine effectiveness and patient safety. This personalized guidance ensures that vaccination strategies align with the individual’s unique health needs and treatment plan.