Flu jabs, vaccines and MS
Can I get the flu jab and other vaccinations if I’ve got MS?
For most people with multiple sclerosis (MS) it makes sense to get the protection that vaccines offer, including the seasonal flu jab. If you get ill with flu or another infection it could make MS symptoms worse. It might even trigger a relapse. And of course the diseases themselves can be serious and in some cases fatal.
You could be offered vaccinations for:
- seasonal flu (influenza)
- whooping cough, if you’re pregnant
- yellow fever, if you’re travelling
The seasonal flu jab is free of charge on the NHS for people with MS and their carer or partner. Find out more about free vaccinations.
Talk to your doctor or MS nurse about which vaccines you should get. You might need to take precautions if:
- you’re having a relapse
- you’ve recently taken steroids for a relapse
- you’re taking certain disease modifying therapies (DMTs)
Vaccines work best when everyone who can take them does take them. This even protects people who can't get vaccinated, because the infection finds it harder to spread. So encourage people around you to have their recommended vaccinations too.
What does COVID-19 mean for vaccines and MS?
There’s no vaccine for the new coronavirus (COVID-19) at the moment. Find out what COVID-19 means for people with MS.
MS, immunisation and travelling
If you’re thinking about travelling, look into vaccines as early as possible. Some take weeks or months to start working. So especially if you’re taking DMTs, try to leave enough time to get advice from your MS team.
MS, pregnancy and vaccines
If you’re pregnant, you’ll be offered the seasonal flu jab and whooping cough vaccines. Again, your doctor can go through any precautions, but most people with MS can take both these vaccines.
Do vaccines cause MS relapses?
Researchers have looked at the results of many different studies to see if vaccines cause relapses. The evidence doesn’t show that vaccines cause relapses.
But if you’ve recently taken certain DMTs or high-dose steroids, many neurologists would suggest avoiding any ‘live’ vaccine. This is because of what we know about the way the immune system works, and because a small study into the live vaccine for yellow fever showed it might increase the chances of having a relapse. The flu jab is not a live vaccine.
There might be times you and your doctor agree the risk of not being vaccinated outweighs the risk of a relapse, even while you’re taking your DMT. For example, if you’re travelling to an area of high risk for a potentially deadly disease.
What is a live vaccine?
A ‘live’ vaccine contains a weak version of the virus or bacteria they prevent. Some MS treatments might not mix well with this kind of vaccine.
Live vaccines include:
- yellow fever
- MMR (measles, mumps, rubella)
- some typhoid vaccines
- flu vaccine nasal spray (usually given to children)
The flu jab, pneumonia and whooping cough vaccines are not live vaccines. They are ‘inactivated’ vaccines, where the virus or bacteria have been killed.
Your doctor or pharmacist can tell you if a vaccine is live or inactivated.
If you’re having an MS relapse, it’s probably wise to avoid vaccines until the relapse has settled. And if you’ve taken steroids to treat the relapse, you might need to wait up to three months before any live vaccine. That’s so your immune system can respond properly to the vaccine.
A pharmacist can tell you which vaccines are live ones. The seasonal flu jab is not, but some travel immunisations are. Talk it through with your neurologist or MS nurse, because there might be times you’d rather get the protection of the vaccine even if you’ve just finished the steroids.
DMTs shouldn’t stop you taking an inactivated vaccine like the seasonal flu jab, pneumonia or whooping cough vaccines.
But some DMTs might not mix well with ‘live’ vaccines like shingles or yellow fever. Speak to your MS Team if you’re thinking of taking any live vaccine.
Before you start treatment with certain DMTs, your neurologist will usually want to check you’re up to date with vaccinations.
This should always be the case with alemtuzumab (Lemtrada), fingolimod (Gilenya), natalizumab (Tysabri) and ocrelizumab (Ocrevus). It might also happen with other DMTs, including teriflunomide (Augabio) and dimethyl fumarate (Tecfidera).
If you have HSCT treatment (stem cell transplantation), you’ll probably need to have vaccinations in the months afterwards so you can re-build your immunity. It’s likely you’ll start with the inactivated vaccines and then a bit later have any live vaccines you need.
Do vaccines work for people with MS?
Some MS treatments might affect the protection a vaccine usually gives.
The flu jab might not work so well for some people taking:
- glatiramer acetate
And possibly with these treatments, although the evidence is less clear:
- teriflunomide (Aubagio)
It doesn’t mean the flu jab definitely won’t work for you if you take one of these treatments, just that it’s less likely. For this and other vaccines, your doctor might offer a blood ‘titre’ test. This can show if a vaccine has worked.
Do hepatitis B or other vaccines cause MS?
Research has not shown that any vaccines cause MS.
There have been suggestions in the past that the hepatitis B vaccine increases the chance of people getting MS. But when researchers weighed up all the studies in 2018, they found no link between the vaccine and MS.
Vaccines for HPV, tetanus, whooping cough and smallpox might even make getting MS less likely.
Making an informed choice about vaccinations
You’re trying to decide what vaccinations to get, so why can’t we just give you a simple answer: take it or don’t take it?
We wish we could, but often your decision will mean weighing up different chances and risks. There are still things we don’t know about the immune system, MS, DMTs and vaccines – and how they all interact. And your circumstances won’t be exactly like other people’s.
That’s why we can tell you what we know, but not what you should do – and why it’s good to get input from your doctor or MS nurse.
If you’ve got a question that doesn’t seem to be answered here, you can contact our MS Helpline for more help.
You don’t have to pay for vaccines that are part of the UK Immunisation Schedule. For example, if you’ve got MS, you and your partner or carer don’t have to pay for the annual flu jab.
And this year, all UK govermnments plan to offer the vaccine to your whole household if you're on the shielding list (those people considered 'extremely clinically vulnerable' to the new coronavirus).
Some travel vaccines, you always have to pay for. Others you might get on the NHS through your GP. Not all GPs do travel vaccinations for free. Find out more at nhs.uk.
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