Should I get a Shingles vaccine if I have Multiple Sclerosis?

Question from and MS patient:  "I am in my early 60s.  Should I get a Shingles vaccine?  I have PPMS and am worried because it is a live virus."

Answer:  The Shingles vaccine is a live attenuated vaccine with a theoretical potential for causing a modified case of chicken pox if given to immunosuppressed individuals. Remember MS patients are not immunosuppressed unless they are given a treatment that suppresses their immune system.

The shingles vaccine has been shown to reduce the risk of shingles by over 60% in patients between 60 and 69 years of age and decrease the severity of shingles in those who do experience shingles despite being vaccinated. This means it is a good idea for most people over the age of 60 to get this vaccine.  The National MS Society and other groups recommend this vaccine in MS patients over the age of 60, but caution against giving this vaccine to patients on therapies that suppress the immune system.

However, a very large study reported in 2012 reported that the shingles vaccine was highly effective and without risk in patients with autoimmune conditions (rheumatoid arthritis, psoriasis and others) on immunosuppressive treatments. Because of this study I tend to recommend the shingles vaccine in almost all MS patients over the age of 60. It is certainly safest and most effective to give the shingles vaccine before beginning an immunosuppressive or immunomodulatory therapy that can increase the risk of shingles, but this is sometimes not possible.

--Dr. Kinkel

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