Vaccination Against Infection in Patients with Multiple Sclerosis

Overview

Journal Nat Rev Neurol

Specialty Neurology

Date 2012 Jan 25

PMID 22270022

Citations 36

Authors

Micha Loebermann

Alexander Winkelmann

Hans-Peter Hartung

Hartmut Hengel

Emil C Reisinger

Uwe K Zettl

Affiliations

Soon will be listed here.

Abstract

Bacterial and viral infections have been shown to induce relapses and accelerate the progression of multiple sclerosis (MS). Vaccination to prevent communicable disease in such patients is, therefore, of key importance. Reports of potentially detrimental effects of immunization on the course of MS, however, have prompted patients and physicians to adopt a cautious attitude towards the use of vaccines. The risks associated with a number of vaccines have been investigated in patients with MS. Vaccines against some diseases, such as tetanus and hepatitis B, are not associated with an elevated risk of MS exacerbation, whereas vaccines against other diseases, such as yellow fever, are contraindicated in patients with MS. Many patients with MS receive immunosuppressive or immunomodulatory therapy, which could make them more susceptible to infectious diseases and might also affect their ability to respond to immunization. Here, we review the indications for and possible adverse effects of vaccines in patients with MS, and address issues of vaccination in the context of immunomodulatory therapy for MS.

Citing Articles

SARS-CoV-2 infection and risk of subsequent demyelinating diseases: national register-based cohort study.

Montgomery S, Vingeliene S, Li H, Backman H, Udumyan R, Jendeberg J Brain Commun. 2024; 6(6):fcae406.

PMID: 39659973 PMC: 11629974. DOI: 10.1093/braincomms/fcae406.

De-escalation and Discontinuation of Disease-Modifying Therapies in Multiple Sclerosis.

Gross R, Corboy J Curr Neurol Neurosci Rep. 2024; 24(9):341-353.

PMID: 38995483 DOI: 10.1007/s11910-024-01355-w.

The effect of COVID-19 vaccination on multiple sclerosis activity as reflected by MRI.

Ganelin-Cohen E, Buxbaum C, Bosak N, Sobol S, Vaknin-Dembinsky A, Hellmann M Brain Behav. 2024; 14(7):e3587.

PMID: 38940313 PMC: 11212002. DOI: 10.1002/brb3.3587.

Blood CD8+ Naïve T-Cells Identify MS Patients with High Probability of Optimal Cellular Response to SARS-CoV-2 Vaccine.

Rodero-Romero A, Sainz De La Maza S, Fernandez-Velasco J, Monreal E, Walo-Delgado P, Chico-Garcia J Vaccines (Basel). 2023; 11(9).

PMID: 37766078 PMC: 10535818. DOI: 10.3390/vaccines11091399.

Side effects following vaccination in multiple sclerosis: a prospective, multi-centre cohort study.

Winkelmann A, Metze C, Zettl U, Loebermann M Sci Rep. 2023; 13(1):14480.

PMID: 37660223 PMC: 10475060. DOI: 10.1038/s41598-023-41271-6.

References

Fomin I, Caspi D, Levy V, Varsano N, Shalev Y, Paran D . Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying drugs, including TNF alpha blockers. Ann Rheum Dis. 2005; 65(2):191-4. PMC: 1798034. DOI: 10.1136/ard.2005.036434. View

Miller A, Morgante L, Buchwald L, Nutile S, Coyle P, Krupp L . A multicenter, randomized, double-blind, placebo-controlled trial of influenza immunization in multiple sclerosis. Neurology. 1997; 48(2):312-4. DOI: 10.1212/wnl.48.2.312. View

Lipnick R, Karsh J, Stahl N, Blackwelder W, Schiffman G, Klippel J . Pneumococcal immunization in patients with systemic lupus erythematosus treated with immunosuppressives. J Rheumatol. 1985; 12(6):1118-21. View

Briggs W, Rozek R, Migdal S, Shillis J, Brackett R, Brandon F . Influenza vaccination in kidney transplant recipients: cellular and humoral immune responses. Ann Intern Med. 1980; 92(4):471-7. DOI: 10.7326/0003-4819-92-4-471. View

Gout O, Lyon-Caen O . [Current opinion 2004: The relationship between multiple sclerosis and hepatitis B vaccination in adults]. Rev Neurol (Paris). 2004; 160(12):1147-9. DOI: 10.1016/s0035-3787(04)71158-3. View

Handel A, Giovannoni G, Ebers G, Ramagopalan S . Environmental factors and their timing in adult-onset multiple sclerosis. Nat Rev Neurol. 2010; 6(3):156-66. DOI: 10.1038/nrneurol.2010.1. View

. Measles pneumonitis following measles-mumps-rubella vaccination of a patient with HIV infection, 1993. MMWR Morb Mortal Wkly Rep. 1996; 45(28):603-6. View

DeStefano F, Verstraeten T, Jackson L, Okoro C, Benson P, Black S . Vaccinations and risk of central nervous system demyelinating diseases in adults. Arch Neurol. 2003; 60(4):504-9. DOI: 10.1001/archneur.60.4.504. View

Mansfield K, Johnson N, Phipps L, Stephenson J, Fooks A, Solomon T . Tick-borne encephalitis virus - a review of an emerging zoonosis. J Gen Virol. 2009; 90(Pt 8):1781-1794. DOI: 10.1099/vir.0.011437-0. View

10.

Wiendl H, Toyka K, Rieckmann P, Gold R, Hartung H, Hohlfeld R . Basic and escalating immunomodulatory treatments in multiple sclerosis: current therapeutic recommendations. J Neurol. 2008; 255(10):1449-63. DOI: 10.1007/s00415-008-0061-1. View

11.

Rowland R, McShane H . Tuberculosis vaccines in clinical trials. Expert Rev Vaccines. 2011; 10(5):645-58. PMC: 3409871. DOI: 10.1586/erv.11.28. View

12.

Veit O, Niedrig M, Chapuis-Taillard C, Cavassini M, Mossdorf E, Schmid P . Immunogenicity and safety of yellow fever vaccination for 102 HIV-infected patients. Clin Infect Dis. 2009; 48(5):659-66. DOI: 10.1086/597006. View

13.

Plotkin S, WIKTOR T . Rabies vaccination. Annu Rev Med. 1978; 29:583-91. DOI: 10.1146/annurev.me.29.020178.003055. View

14.

Ristori G, Buzzi M, Sabatini U, Giugni E, Bastianello S, Viselli F . Use of Bacille Calmette-Guèrin (BCG) in multiple sclerosis. Neurology. 1999; 53(7):1588-9. DOI: 10.1212/wnl.53.7.1588. View

15.

Meyer-Olson D, Witte T . Immunology: Prevention of infections in patients with autoimmune diseases. Nat Rev Rheumatol. 2011; 7(4):198-200. DOI: 10.1038/nrrheum.2011.14. View

16.

Salemi S, DAmelio R . Could autoimmunity be induced by vaccination?. Int Rev Immunol. 2010; 29(3):247-69. DOI: 10.3109/08830181003746304. View

17.

Sutton I, Lahoria R, Tan I, Clouston P, Barnett M . CNS demyelination and quadrivalent HPV vaccination. Mult Scler. 2008; 15(1):116-9. DOI: 10.1177/1352458508096868. View

18.

Wagner D, Wagenbreth I, Thoma H, Hemmerling A, Flik J . Hepatitis B vaccination of immunosuppressed heart transplant recipients with the vaccine Hepa Gene 3 containing pre-S1, pre-S2, and S gene products. Clin Investig. 1994; 72(5):350-2. DOI: 10.1007/BF00252826. View

19.

Anderson E . Rotavirus vaccines: viral shedding and risk of transmission. Lancet Infect Dis. 2008; 8(10):642-9. DOI: 10.1016/S1473-3099(08)70231-7. View

20.

Farez M, Ysrraelit M, Fiol M, Correale J . H1N1 vaccination does not increase risk of relapse in multiple sclerosis: a self-controlled case-series study. Mult Scler. 2011; 18(2):254-6. DOI: 10.1177/1352458511417253. View