Which yearly vaccinations are safe for the MS patient? My primary doctor wants a flu, pneumonia and shingles vaccination, but I am not sure they are safe with a compromised immune system.
There is no single answer when it comes to vaccinations. Whether an individual should be vaccinated depends on their risk factors and age. You should discuss this with your doctor. Generally speaking all MS patients, even immunosuppressed patients, may receive inactivated vaccines as required by circumstances or on a regular basis. However, an immunosuppressed patient may not be able to benefit from an inactivated vaccine as well as required (i.e. you may not mount a protective immune response).
Live or live attenuated vaccines should be avoided in pregnant and immunocompromised patients unless required because of an epidemic. Remember, as an MS patient you ARE NOT immunocompromised unless you receive a treatment that could definitely or potentially create immunosuppression. Even then most patients will likely mount a relatively normal immune response to vaccinations.
Medications definitely associated with immunosuppression include chronic steroids (not just occasional steroids for a relapse), azathioprine, methotrexate, cyclophosphamide (cytoxan), mitoxantrone, cyclosporin and mycophenolate (cellcept) to name a few medications possibly associated with immunosuppression include Aubagio, Gilenya and Tysabri.
The list of live attenuated viruses to avoid if pregnant or immunocompromised include the following:
- Flumist Nasal Spray (the injectable flu vaccine is inactivated and safe in all MS patients)
- Shingles vaccine: This is why doctors often give this vaccine BEFORE putting you on a medication that can compromise your immune system
- Yellow fever
- Typhoid (also comes in an inactivated vaccine)
- Adenovirus (given to military personnel)
- Rotavirus for infants
- Measles, mumps and rubella given in children
- Chickenpox vaccine in children (same virus that causes shingles)
So the yearly injectable flu vaccine is safe and the one time pneumonia vaccine is safe
The Shingles vaccine is safe if your doctor does not think you are immunocompromised. It is also only recommended if you are over 50.
Here are previous blogs you might be interested in regarding shots for the flu and shingles: