MS and vaccines must have a carefully balanced relationship
DEAR DR. ROACH: I have multiple sclerosis. I have been told NOT to get the shingles vaccine by one doctor, and I have been told TO get the shot by another. I had the shingles twice a long time ago. Does the fact that it is a live culture have an effect on the recommendation? -- D.M.
ANSWER: Multiple sclerosis is an autoimmune disease that may be triggered by the increase in the immune system response following some vaccinations. That has to be balanced against the benefits of not getting the disease. There remains controversy about this, and you must, of course, discuss it with your neurologist.
However, the National Multiple Sclerosis Society has made some recommendations, with which I agree. It concluded that influenza, hepatitis B, varicella and tetanus vaccines are safe for people with MS. Most live, attenuated vaccines are not recommended. These include the live flu vaccine (given by nasal spray; flu shots are not live vaccines, and flu shots are generally considered safe) and yellow fever vaccine, which is controversial. The current shingles vaccine Zostrix, even though it is a live, attenuated vaccine, is considered safe, because almost everybody in the age group of MS has had chickenpox and thus has the virus already in the body.