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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. Gavin Giovannoni1,2
  1. 1Neuroscience and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 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, Royal London Hospital, 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, Queen Mary University of London, 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; s.reyes{at}


Vaccines are key to preventing contagious, or serious, infections. However, their use in people with multiple sclerosis (pwMS) has often been problematic because of misguided concerns that vaccinations may exacerbate the disease and also because some disease-modifying therapies (DMTs) may influence the immune response to immunisations and/or their safety. PwMS may have 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—DMTs, vaccination during pregnancy, pretravel counselling and patient education. Our aim is to endorse vaccination as one of the most efficient methods for protecting pwMS from infections and to provide a framework to ensure vaccinations are safe and effective.

  • Immunology
  • Multiple Sclerosis
  • Neuroimmunology
  • Infectious Diseases
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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.

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

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