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Vaccination Safety

Recent studies continue to affirm the safety of vaccinations for people with MS. An evaluation of several reports and trial outcomes by the US Penitentiary Health Services Unit in Terre Haute, IN, concluded that the hepatitis B (HB), influenza, and tetanus vaccines do not increase the risk of developing MS or exacerbating its symptoms.

Although an acute central demyelinating event following HB vaccination was reported in a portion of those vaccinated in France between 1991 and 1999 (several hundred out of roughly 12 million vaccinated), follow-up studies failed to establish the causality of the HB vaccine. The Centers for Disease Control and Prevention in Atlanta, GA, report that immunizations are unlikely to be a major cause of autoimmune disease (AID), but point out the need for additional epidemiological studies to asses the risk in some susceptible individuals. While some evidence for immunization leading to AID comes from several sources including animal studies, more rigorous (or scientifically accurate) investigation has failed to confirm most of these claims.

A case-crossover study (at the European Database for Multiple Sclerosis Coordinating Center and the Service de Neurologie A, Hospital Neurologique in Lyons, France) was conducted to determine if vaccinations increased the risk of relapse in MS. Researchers contacted 643 individuals with MS who experienced a relapse between 1993 and 1997, but who had no other disease exacerbation for at least one year prior to that time. Relapses were confirmed by visits to the neurologist, and information on vaccinations was confirmed through medical records.

No evidence of specific risk for relapse was associated with tetanus, HB, or influenza vaccinations. Researchers concluded that vaccines do not appear to increase the short-term risk of relapse in MS.

An earlier article written by AE Miller, et al, for Neurology, provides results of a multicenter, randomized, double-blind, placebo-controlled trial of influenza immunization in MS. The article states, “Prevention of a febrile viral illness is clearly desirable in MS, and previous studies suggest that immunization is safe. Despite this, many clinicians avoid vaccination because they fear precipitating an MS exacerbation.”

More than 100 people with MS at five MS centers were given the standard influenza vaccine or a placebo. The researchers concluded, “The two groups showed no difference in attack rate or disease progression over six months. Influenza immunization in MS patients is neither associated with an increased exacerbation rate in the post-vaccination period nor a change in disease course over the subsequent six months.”

These studies and others continue to support the safety of vaccinations for individuals with MS. This is good news for people who would like to have added protection against one of the previously mentioned illnesses (hepatitis B, tetanus, and influenza). Individuals with MS should consult their physician before receiving any vaccination to be sure that other health conditions would not be affected.

Sources for this article include:

Chen RT, et al, Epidemiology of autoimmune reactions induced by vaccination, Journal of Autoimmunity, vol. 16 (3) pp. 309-318, May 2001.

Confavreux C., et al, Vaccinations and the risk of relapse in multiple sclerosis, New England Journal of Medicine, vol. 344 (5), pp. 319-326, Feb. 2001.

Gout O, Vaccinations and multiple sclerosis, Neurological Sciences, vol. 22 (2), pp. 151-154, April 2001.

Miller AE, et al, A multicenter randomized, double-blind, placebo-controlled trial of influenza immunization in multiple sclerosis, Neurology, vol. 48 (2), pp. 312-314, Feb. 1997.

Sievers EJ, Heyneman CA, Relationship between vaccinations and multiple sclerosis, Annals of Pharmacotherapy, vol. 36 (1), pp. 160-162, Jan. 2002.

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