Influenza vaccination and MS - harry206

[ArchivalUser]

Will Influenza vaccination cause the exacerbation of MS ?

[ArchivalUser]

MS= Multiple Sclerosis

[ArchivalUser]

Jason FM book says:

Vaccinations, including influenza vaccine, had been posited as a cause of exacerbations. However, a review of multiple clinical trials showed no increased risk of exacerbations in patients with multiple sclerosis receiving the influenza, hepatitis B, or tetanus vaccinations.

Plz answer (with valid source or link if possible)

Thanks

[ArchivalUser]

Hepatitis B: The dilemma in hepatitis B vaccination occurs in those patients suffering from known MS. While the evidence suggesting that hepatitis B vaccine may aggravate disease activity in MS has arisen from case reports and small, uncontrolled series, only those MS patients at high risk for hepatitis B should be vaccinated until results of larger, well-controlled studies are available. If a patient with diagnosed MS has risk factors for hepatitis B, the vaccine should be administered; patients should be told that the question of relapse following hepatitis B vaccination is controversial, but that there is no strong evidence showing an increased risk of relapse or disease progression following vaccination.

Flu shot:When the benefits versus the risk of influenza vaccination are considered, it is clear that in the vast majority of cases there is considerable benefit to vaccination. In patients with advanced disability, influenza may constitute a life-threatening illness. Even in those with minimal disability, severe flu may be followed by secondary bacterial infection. Further, the risk of relapse following influenza may be as high as 33%, whereas the risk of relapse following vaccination appears to be negligible.[11] The only exception to this general rule would be in those patients with rapidly evolving neurologic deficits due to active disease. In that instance, vaccination should probably be withheld pending treatment with high-dose corticosteroids to suppress inflammatory disease activity or stabilization through the use of immunomodulatory treatment, such as interferon-b (IFN-b) or glatiramer (GLAT). Further, there is no contraindication to vaccination in MS patients receiving IFN-b or GLAT. Care should be taken in those patients being treated with methotrexate, azathioprine, or other chemotherapeutic agents, since these drugs are more potent and less specific in their immunosuppressant effect. In the absence of active disease, influenza vaccination is strongly recommended for patients with MS.


http://www.medscape.com/viewarticle/429479_3

[ArchivalUser]

Hepatitis B: The dilemma in hepatitis B vaccination occurs in those patients suffering from known MS. While the evidence suggesting that hepatitis B vaccine may aggravate disease activity in MS has arisen from case reports and small, uncontrolled series, only those MS patients at high risk for hepatitis B should be vaccinated until results of larger, well-controlled studies are available. If a patient with diagnosed MS has risk factors for hepatitis B, the vaccine should be administered; patients should be told that the question of relapse following hepatitis B vaccination is controversial, but that there is no strong evidence showing an increased risk of relapse or disease progression following vaccination.

Flu shot:When the benefits versus the risk of influenza vaccination are considered, it is clear that in the vast majority of cases there is considerable benefit to vaccination. In patients with advanced disability, influenza may constitute a life-threatening illness. Even in those with minimal disability, severe flu may be followed by secondary bacterial infection. Further, the risk of relapse following influenza may be as high as 33%, whereas the risk of relapse following vaccination appears to be negligible.[11] The only exception to this general rule would be in those patients with rapidly evolving neurologic deficits due to active disease. In that instance, vaccination should probably be withheld pending treatment with high-dose corticosteroids to suppress inflammatory disease activity or stabilization through the use of immunomodulatory treatment, such as interferon-b (IFN-b) or glatiramer (GLAT). Further, there is no contraindication to vaccination in MS patients receiving IFN-b or GLAT. Care should be taken in those patients being treated with methotrexate, azathioprine, or other chemotherapeutic agents, since these drugs are more potent and less specific in their immunosuppressant effect. In the absence of active disease, influenza vaccination is strongly recommended for patients with MS.


http://www.medscape.com/viewarticle/429479_3

[ArchivalUser]

Thanks for the explanation the1.