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Protecting people with multiple sclerosis through vaccination
  1. Saúl Reyes1,2,
  2. Mary Ramsay3,
  3. Shamez Ladhani3,
  4. Gayatri Amirthalingam3,
  5. Neena Singh2,
  6. Carlos Cores1,
  7. joela Mathews4,
  8. Jonathan Lambourne5,
  9. Monica Marta1,2,
  10. Benjamin Turner2,
  11. Sharmilee Gnanapavan1,2,
  12. Ruth Dobson2,6,
  13. Klaus Schmierer1,2,
  14. G Giovannoni1,2
  1. 1Neuroscience and Trauma, Blizard Institute of Cell and Molecular Science, London, UK
  2. 2Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK
  3. 3Immunisation and Countermeasures Division, Public Health England, London, UK
  4. 4Pharmacy Service, Barts Health NHS Trust, London, UK
  5. 5Department of Microbiology and Infectious Diseases, Barts Health NHS Trust, London, UK
  6. 6Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, London, UK
  1. Correspondence to Saúl Reyes, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark St, Whitechapel, London E1 2AT, UK; saul.reyes{at}


Vaccination is one of the most effective and cost-efficient methods for protecting people with multiple sclerosis (MS) from infections. However, use of vaccines has often been problematic because of misguided concerns that they may exacerbate the disease and/or that some disease-modifying therapies may influence the immune response to immunisations and/or their safety. People with MS risk higher morbidity and mortality from vaccine-preventable infections. It is, therefore, important to address any patient’s reluctance to accept vaccination and to provide clear guidance for clinicians on which vaccinations to consider proactively. We have reviewed the current literature and provide recommendations regarding vaccines in adults with MS, including specific advice regarding vaccination safety in patients receiving—or going to receive—disease-modifying therapies, vaccination during pregnancy, pretravel counselling and patient education.

  • Immunology
  • Multiple Sclerosis
  • Neuroimmunology
  • Epilepsy
  • Trigeminal Neuralgia
  • Infectious Diseases
  • Myelopathy
  • Tuberculosis
  • Biochemistry
  • Magnetic Stimulation
  • Stiff Man Syndrome
  • Postmortem
  • Mri
  • Lambert-Eaton Syndrome
  • Paraproteinaemia
  • CSF

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  • Twitter G Giovannoni @gavingiovannoni.

  • Contributors SR and GG conceived the review. SR, NS and GG wrote the first draft of the manuscript. All the authors participated in the critical revision of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethical approval information Not applicable.

  • Data sharing statement Not applicable.

  • Provenance and peer review Not commissioned; externally peer reviewed by Neil Scolding, Bristol, UK.

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