Protecting people with multiple sclerosis through vaccination.

Vaccines are key to preventing contagious, or serious, infections. However, their use in people with multiple sclerosis (pwMS) has often been problematic because of misguided concerns that vaccinations may exacerbate the disease and also because some disease-modifying therapies (DMTs) may influence the immune response to immunisations and/or their safety. PwMS may have higher morbidity and mortality from vaccine-preventable infections. It is, therefore, important to address any patient's reluctance to accept vaccination and to provide clear guidance for clinicians on which vaccinations to consider proactively. We have reviewed the current literature and provide recommendations regarding vaccines in adults with MS, including specific advice regarding vaccination safety in patients receiving-or going to receive-DMTs, vaccination during pregnancy, pretravel counselling and patient education. Our aim is to endorse vaccination as one of the most efficient methods for protecting pwMS from infections and to provide a framework to ensure vaccinations are safe and effective. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.