Understanding Vaccine Recommendations and Multiple Sclerosis

Vaccines teach the immune system to protect the body from infection. Because illness can worsen the symptoms of multiple sclerosis (MS), preventing infection is key to managing MS.^1-3

Many people living with MS have questions about which vaccinations they could or should get. In general, experts recommend that people with MS receive vaccinations according to standard vaccine guidelines.^1,2

However, some drugs that suppress the immune system can affect which vaccines you should get and when they can be given. This includes disease-modifying therapies (DMTs) and steroids. Ask your doctor if you are taking any drugs that could affect which vaccines you should get.¹

Do vaccines cause MS?

Multiple studies have shown no link between vaccination and onset or relapse of MS. Getting sick is more likely than vaccination to trigger MS symptoms. But if you are currently having an MS relapse, experts recommend waiting to get vaccinated. Your doctor will advise you about vaccine timing.^2-5

Which vaccines are not safe for people with MS?

Some vaccines contain weakened live viruses. This type of vaccine is not recommended for people who are taking drugs that suppress the immune system.²

Common adult vaccines

Some common adult vaccines are discussed below. In general, vaccine recommendations vary based on:^5,6

• Age
• Job
• Travel
• Medical conditions and other risk factors

Influenza (flu)

The flu vaccine is updated annually. Experts recommend that people with MS should receive the flu vaccine every year.²

One type of flu vaccine – FluMist® nasal spray – is a live vaccine. But flu vaccine shots do not contain the live virus. Experts recommend that people with MS who are taking a DMT get the shot rather than the nasal spray.²

COVID-19

People with progressive MS, higher levels of physical disability, and other medical conditions are at increased risk of hospitalization from COVID-19.^7,8

As of May 2023, experts recommend that everyone 6 years and older should receive 1 updated Pfizer-BioNTech or Moderna COVID-19 vaccine. People with a weakened immune system may need additional boosters.^7,8

COVID-19 vaccines do not contain a live virus. You cannot get COVID-19 from the vaccine. People on DMTs for MS can safely get the COVID-19 vaccine.^7,8

It is safe to get the flu vaccine and COVID-19 vaccine at the same time. Consult the CDC guidelines for the most up-to-date recommendations about the COVID-19 vaccine.^7,8

Shingles (Shingrix®)

Shingles occurs when the virus that causes chickenpox (varicella-zoster) is reactivated. This virus can remain inactive in the body for many years. Shingles causes a painful rash on one side of the face or body. It can cause long-term nerve pain and other serious complications.^2,9

Shingrix® is a 2-dose vaccine that can prevent shingles. It is recommended for people 50 or older. People over age 19 taking some MS drugs should also consider getting this vaccine. Shingrix® is not a live vaccine. You can get it even if you are on DMTs.^2,9

Varicella (chickenpox)

The chickenpox vaccine contains a weakened form of the varicella-zoster virus. It is recommended for children and adults who have not had chickenpox. This vaccine is not recommended for people with a weakened immune system or active illness.¹⁰

If you are on steroids or DMTs, talk with your doctor before receiving this vaccine. And avoid close contact with recently vaccinated people for up to 6 weeks if you are at high risk due to illness or a weakened immune system.¹⁰

Pneumococcal (pneumonia)

The pneumococcal vaccine helps protect against a type of bacteria called Streptococcus pneumoniae. This bacterium can cause severe and even life-threatening infections.^2,6,11

Pneumococcal vaccines do not contain a live virus. Doctors give this vaccine to children, adults over 65, and adults with other high-risk medical conditions.^2,6,11

You may be at higher risk of illness from S. pneumoniae if you:^2,6,11

• Take medicines that suppress the immune system
• Use a wheelchair
• Are bed-bound
• Have breathing problems

Other vaccines

Other common vaccines include:^5,6,12

• Human papillomavirus (HPV) (Gardasil®) – Prevents certain types of cancer and genital warts caused by specific high-risk strains of HPV
• Hepatitis B – Prevents serious liver disease from the hepatitis B virus
• Tdap – Prevents serious bacterial infections, including tetanus, diphtheria, and pertussis (whooping cough)
• Mpox – A 2-dose vaccine for people at high risk of exposure to the mpox virus

Read the CDC guidelines for a complete list of vaccines.⁶

Vaccine side effects

Side effects can vary depending on the specific vaccine you are taking. Most vaccine side effects are mild, and serious reactions are rare. Common side effects include:⁵

• Fever
• Fatigue
• Body aches
• Redness, tenderness, or swelling at the injection site

These are not all the possible side effects of vaccines. Talk to your doctor about what to expect when receiving vaccines. You also should call your doctor if you have any changes that concern you after receiving a vaccine.

Vaccines are generally a safe and effective way to prevent many serious illnesses, hospitalization, and even death. In most cases, people living with MS should follow standard vaccine guidelines. But before receiving any vaccines, talk with your doctor to see which ones are best for you.⁵