What are the American Academy of Neurology (AAN) guidelines for vaccine-preventable infections and immunization in multiple sclerosis (MS)?

Updated: Oct 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

In 2019, the American Academy of Neurology (AAN) issued guidelines for vaccine-preventable infections and immunization in multiple sclerosis. Recommendations include the following: [147]

  • Discuss the evidence regarding immunizations in MS with patients.
  • Recommend that MS patients follow all local vaccine standards, unless there are specific contraindications.
  • Recommend annual influenza vaccination to MS patients.
  • Counsel MS patients about infection risks associated with specific immunosuppressive/ immunomodulating (ISIM) medications and treatment-specific vaccination guidance according to prescribing information (PI).
  • Vaccinate patients with MS as needed at least 4–6 weeks before initiating ISIM therapy.
  • Screen for infections according to PI before initiating ISIM medications and treat patients testing positive for latent infections. In high-risk populations, screen for latent infections before starting ISIM therapy even when not specifically mentioned in PI.
  • Recommend against using live-attenuated vaccines in MS patients receiving ISIM therapies.
  • Delay vaccination in MS patients experiencing a relapse.

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