Although there is a particular risk of infection, patients with multiple sclerosis (MS) are often not vaccinated in accordance with specialist recommendations. A recently published observational study by Jena University Hospital identifies the reluctance of general practitioners as one reason for this and recommends the establishment of MS vaccination centers.
Vaccinations are one of the most effective measures to protect against serious infections. This prevention is particularly important for people with chronic illnesses. If the underlying disease is immune-mediated and its treatment weakens the immune system, vaccination protection becomes even more important. The treatment guidelines for chronic inflammatory diseases take this into account and recommend complete immunization, even against rarer infectious diseases, coordinated with the treatment cycles and the respective therapies.
Extended vaccination protection recommended
A study by Jena University Hospital (UKJ) investigated how these recommendations are implemented in patients with multiple sclerosis. The disease, known as MS for short, is an autoimmune chronic inflammation that affects the central nervous system and often progresses in episodes. There are around 250,000 people affected in Germany. They are usually treated in specialized MS centers or neurological practices. Depending on the phase of the disease, more than 20 different therapies and active substances are available, which intervene in the immune system to varying degrees. In addition to the generally recommended standard vaccinations, MS sufferers should also be vaccinated with vaccinations specifically for people with a weakened immune system. If possible, immunization should take place before the initiation of immunotherapy.
The new observational study recorded the vaccination status of almost 400 patients, their level of information and their attitude towards vaccination in six specialized MS treatment centers in different regions in Germany. The general practitioners who administer the vaccinations were also surveyed. As a result, MS patients only had a good half of the recommended standard vaccinations. In an age-matched healthy comparison group, the vaccination rate was even slightly higher. Less than one in five people with MS were sufficiently vaccinated against shingles, influenza or other respiratory diseases. This also applied to MS patients on highly effective immunosuppressive medication. The groups did not differ in terms of their attitude towards vaccination, with only a few showing a skeptical attitude.
GPs have reservations
The situation was different for the 109 GP practices participating in the study: 82% stated that they had reservations about vaccinating their MS patients due to possible side effects or interactions with medication. This uncertainty is understandable, as each GP practice looks after fewer than ten MS patients on average."We repeatedly hear fears from both GPs and patients that vaccinations could trigger relapses or worsen the course of MS," says study leader PD Dr. Florian Rakers."There is no evidence for this. However, it is certain that infections can have a negative impact on MS." The neurologist therefore suggests that some MS treatment centers should be established as specialized vaccination centers. This could help to ensure that patients receive care in line with the guidelines.
