MS and vac­cines must have a care­fully bal­anced re­la­tion­ship

Ripon Bulletin - - Local / State - TO YOUR GOODHEALTH Keith Roach, M.D.

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.

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