Vaccinations and the Risk of Relapse in Multiple Sclerosis

The safety of vaccinations in patients with multiple sclerosis has been debated for decades. 1 Clinical onset and relapses of multiple sclerosis after vaccination have been reported. 2 – 20 The results of post-marketing surveillance studies 21 – 28 and small studies of the safety of influenza vaccination in patients with multiple sclerosis 29 – 36 have been reassuring. However, most clinicians are still reluctant to vaccinate patients with multiple sclerosis. Recently, there have been reports of onset or relapse of multiple sclerosis after the extensive immunization program in France against hepatitis B. 20 , 28 , 37 – 39 To assess whether vaccination increases the short-term risk of relapse in . . .