Vaccinations in patients with multiple sclerosis: review and recommendations

• 1 Alfred Health, Melbourne, VIC
• 2 Monash University, Melbourne, VIC
• 3 University of Melbourne, Melbourne, VIC
• 4 VCS Foundation, Melbourne, VIC
• 5 Concord Repatriation General Hospital, Sydney, NSW

---

• 1. Buljevac D, Flach HZ, Hop WCJ, et al. Prospective study on the relationship between infections and multiple sclerosis exacerbations. Brain 2002; 125: 952–960.
• 2. Bua A, Ruggeri M, Zanetti S, et al. Effect of teriflunomide on QuantiFERON-TB Gold results. Med Microbiol Immunol 2017; 206: 73–75.
• 3. Loebermann M, Winkelmann A, Hartung H-P, et al. Vaccination against infection in patients with multiple sclerosis. Nat Rev Neurol 2012; 8: 143–151.
• 4. Olberg HK, Eide GE, Cox RJ, et al. Antibody response to seasonal influenza vaccination in patients with multiple sclerosis receiving immunomodulatory therapy. Eur J Neurol 2018; 25: 527–534.
• 5. Australian Technical Advisory Group on Immunisation. Australian immunisation handbook. Canberra: Australian Government Department of Health, 2018. https://immunisationhandbook.health.gov.au (viewed Sept 2020).
• 6. Breuer J, Schmid DS, Gershon AA. Use and Limitations of varicella-zoster virus-specific serological testing to evaluate breakthrough disease in vaccinees and to screen for susceptibility to varicella. J Infect Dis 2008; 197: S147–S151.
• 7. Tricco AC, Zarin W, Cardoso R, et al. Efficacy, effectiveness, and safety of herpes zoster vaccines in adults aged 50 and older: systematic review and network meta-analysis. BMJ 2018; 363: 4029.
• 8. Centers for Disease Control and Prevention. Measles, mumps, and rubella (MMR) vaccination: what you should know. https://www.cdc.gov/vaccines/vpd/mmr/public/index.html (viewed Sept 2020).
• 9. Farez MF, Correale J, Armstrong MJ, et al. Practice guideline update summary: vaccine-preventable infections and immunization in multiple sclerosis. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2019; 93: 584–594.
• 10. Mailand MT, Frederiksen JL. Vaccines and multiple sclerosis: a systematic review. J Neurol 2017; 264: 1035–1050.
• 11. Farez MF, Correale J. Yellow fever vaccination and increased relapse rate in travelers with multiple sclerosis. Arch Neurol 2011; 68: 1267–1271.
• 12. Rutschmann OT, McCrory DC, Matchar DB. Immunization Panel of the Multiple Sclerosis Council for Clinical Practice Guidelines. Immunization and MS: a summary of published evidence and recommendations. Neurology 2002; 59: 1837–1843.
• 13. Centers for Disease Control and Prevention. Pregnancy and vaccination. https://www.cdc.gov/vaccines/pregnancy/index.html (viewed Sept 2020).
• 14. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58: 309–318.
• 15. Coyle PK. Switching therapies in multiple sclerosis. CNS Drugs 2013; 27: 239–247.
• 16. Centers for Disease Control and Prevention. CDC yellow book 2020: health information for international travel. New York: Oxford University Press, 2019.
• 17. Bar-Or A, Wiendl H, Miller B, et al. Randomized study of teriflunomide effects on immune responses to neoantigen and recall antigens. Neurol Neuroimmunol Neuroinflamm 2015; 2: e70.
• 18. Bar-Or A, Freedman MS, Kremenchutzky M, et al. Teriflunomide effect on immune response to influenza vaccine in patients with multiple sclerosis. Neurology 2013; 81: 552–558.
• 19. von Hehn C, Howard J, Liu S, et al. Immune response to vaccines is maintained in patients treated with dimethyl fumarate. Neurol Neuroimmunol Neuroinflamm 2018; 5: e409.
• 20. Kappos L, Mehling M, Arroyo R, et al. Randomized trial of vaccination in fingolimod-treated patients with multiple sclerosis. Neurology 2015; 84: 872–879.
• 21. Australian Product Information. Mavenclad (cladribine) tablets. https://apps.medicines.org.au/files/sgpmaven.pdf (viewed Jan 2021).
• 22. Giovannoni G, Comi G, Cook S, et al. A placebo-controlled trial of oral cladribine for relapsing multiple sclerosis. N Engl J Med 2010; 362: 416–426.
• 23. Kaufman M, Pardo G, Rossman H, et al. Natalizumab treatment shows no clinically meaningful effects on immunization responses in patients with relapsing-remitting multiple sclerosis. J Neurol Sci 2014; 341: 22–27.
• 24. Vågberg M, Kumlin U, Svenningsson A. Humoral immune response to influenza vaccine in natalizumab-treated MS patients. Neurol Res 2012; 34: 730–733.
• 25. McCarthy CL, Tuohy O, Compston DAS, et al. Immune competence after alemtuzumab treatment of multiple sclerosis. Neurology 2013; 81: 872–876.
• 26. Cooles FAH, Anderson AE, Drayton T, et al. Immune reconstitution 20 years after treatment with alemtuzumab in a rheumatoid arthritis cohort: implications for lymphocyte depleting therapies. Arthritis Res Ther 2016; 18: 302.
• 27. Bar-Or A, Calkwood JC, Chognot C, et al. Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis: the VELOCE study. Neurology 2020; 95: e1999–e2008.
• 28. Australian Product Information. Ocrevus (ocrelizumab). http://www.guildlink.com.au/gc/ws/ro/pi.cfm?product=ropocrev10717 (viewed Sept 2020).
• 29. Clem AS. Fundamentals of vaccine immunology. J Global Infect Dis 2011; 3: 73.
• 30. Mulero P, Auger C, Parolin L, et al. Varicella-zoster meningovasculitis in a multiple sclerosis patient treated with natalizumab. Mult Scler 2018; 24: 358–360.
• 31. Malaiya R, Patel S, Snowden N, et al. Varicella vaccination in the immunocompromised. Rheumatology 2015; 54: 567–569.
• 32. Huttner A, Eperon G, Lascano AM, et al. Risk of MS relapse after yellow fever vaccination: A self-controlled case series. Neurol Neuroimmunol Neuroinflamm 2020; 7: e726.
• 33. Thomas RE, Lorenzetti DL, Spragins W, et al. The safety of yellow fever vaccine 17D or 17DD in children, pregnant women, HIV+ individuals, and older persons: systematic review. Am J Trop Med Hyg 2012; 86: 359–372.
• 34. Garland SM, Brotherton JML, Moscicki AB, et al. HPV vaccination of immunocompromised hosts. Papillomavirus Res 2017; 4: 35–38.
• 35. Brand A, Hammond I, Pather S, et al. National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding. Screening in immune-deficient women. Sydney: Cancer Council Australia, 2018. https://wiki.cancer.org.au/australia/Clinical_question:Screening_in_immune-deficient_women (viewed Sept 2020).
• 36. Australian Government Department of Health. Providing cervical screening. https://www.health.gov.au/initiatives-and-programs/national-cervical-screening-program/providing-cervical-screening (viewed Mar 2021).