Vaccinations recommandées pour les patients traités pour une SEP

Under immunomodulatory treatments (beta interferons and glatiramer acetate), there are no vaccine restrictions.

Under immunosuppressive treatment or in a situation of immunosuppression, live attenuated vaccines are contraindicated (see below for the intervals to be respected between vaccinations and treatments). Recommended vaccines are, on one hand, those from the current vaccination schedule for the general population and, on the other hand, those specifically recommended for immunocompromised individuals (especially flu and pneumococcal vaccines).

Vaccination of the immediate environment of an immunocompromised person is recommended: against seasonal flu with the inactivated vaccine and against chickenpox in case of negative serology.

Annual vaccination against seasonal flu:

• is recommended for patients treated with immunosuppressants or with significant disabilities, or in other cases where flu vaccination is recommended (unless there is a specific contraindication);
• can be proposed for all other MS patients.

A booster dose of the anti-SARS-CoV-2 vaccine is recommended once a year for MS patients at risk of severe Covid (i.e., age ≥ 65 years; immunosuppressive treatment [2 boosters/year]; significant disability; pregnancy) and for individuals in their immediate environment or in regular contact with them.

Furthermore, it is recommended to administer an additional injection during the primary vaccination against SARS-CoV-2 to patients treated with anti-CD20.

For shingles vaccination, the Shingrix vaccine, now available, is preferentially recommended by the French Health Authority since 2024 (more effective than Zostavax, which is also contraindicated in MS patients).

With the new pneumococcal vaccine Prevenar 20, only one injection is required.

Table 1 summarizes the recommended vaccinations for patients treated for MS.