Some studies show that viral infections can increase MS relapse rate, presumably by activating the immune system. New information, presented by Dr Patricia Coyle at the 2014 Meeting of CMSC and ACTRIMS, confirms that nearly all vaccinations are safe for patients with MS. The seasonal flu vaccine is well studied, and the killed virus is considered safe. Similarly, vaccines for hepatitis B, varicella (shingles), tetanus, and HPV are accepted as safe. Killed vaccines rather than live should be used whenever possible.

Disease-modifying drugs, including beta interferons, Copaxone, Tysabri, and Aubagio do not affect the body’s immune responses to vaccines. There are no data about Tecfidera’s effect on vaccine responses, and administrating live vaccines to patients on this drug is not recommended. Fingolimod may have some effect. Patients should be checked for previous infections to zoster (chicken pox) before starting the drug. If these are not found, patients should be vaccinated, and starting therapy should be delayed for a month. Live vaccines should not be given to patients on this drug.

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Dr. Jack Florin
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