Attitudes Toward Vaccines in People with Multiple Sclerosis

Thursday, May 31, 2018
Exhibit Hall A (Nashville Music City Center)
Lien Nguyen, DO , Neurology, University of Washington, Seattle, WA
Kevin N Alschuler, PhD , Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
Annette Wundes, MD , Neurology, University of Washington, Seattle, WA
Gloria von Geldern, MD , University of Washington, Seattle, WA
Lakshman Arcot Jayagopal, MD , University of Washington, Seattle, WA


Treatment of multiple sclerosis (MS) has become more complex as more medications with drastic effect on the immune system are used to prevent disease activity. Clinicians treating MS need to address the risk of infections. Thus, understanding immunization behavior is increasingly important in providing care for people with MS. 


To characterize the attitudes of people with MS towards vaccines.


An anonymous questionnaire was used to query the attitudes of people with MS to vaccines. Survey participants were 198 people with definite MS attending the UW MS Center for routine care; the mean age was 48.5 (SD 12.7), 67% were female and 88% were white. Patients had MS for an average of 11 years (SD 9.9), 31.8% had a self-reported EDSS greater than 6, and 17.9% were not on any disease modifying therapy (DMT).  


In our survey, only 40.7% reported that a health care professional had discussed vaccines with them. Most patients thought vaccines were safe (79.3%) and believed that the benefits of vaccines outweigh the risks (82.4%). When asked about specific vaccines, only 62.8% reported getting a yearly influenza vaccine. Reasons for not getting a flu vaccine ranged from safety concerns to being too busy. A majority of those > 65 (16/24, 66.7%) had received a pneumonia vaccine and half (20/40) of those > 60 had received a shingles vaccine as recommended.

Opinions about the role of vaccines in MS differed widely. Similar proportions thought that vaccines are more important in those with MS (44.7%), or disagreed or strongly disagreed with that statement (42.35%). Age, gender, race, duration of MS, disability, gender, education status and DMT were not correlated with whether people thought vaccines were more important in MS or not. The perception of vaccines as dangerous was also not correlated with duration of MS, disability, gender, or education status but there was a correlation with age (r0.16, p0.036). Few patients (15.2%) were concerned that vaccines worsen MS. While several DMT prohibit the use of live vaccines, only 10.7% of patients stated that vaccines may not be safe while on MS drugs. 


While attitudes to vaccines were generally positive, specific knowledge about vaccines in people with MS was lacking and a large percentage of those surveyed had not talked to a healthcare provider about vaccines. This study highlights the importance of educating people with MS about the role and safety of vaccines in their specific situation.