Many Patients With Multiple Sclerosis Harbor Misconceptions About Vaccinations

A team of researchers surveyed patients with multiple sclerosis to determine if influenza vaccine uptake would not meet public health targets.

Vaccine uptake was found to be decreased among the multiple sclerosis (MS) patient population, coupled with misconceptions about vaccine safety. These findings, from a cross-sectional study, were published in Neurology Clinical Practice.

Researchers invited members of the North American Research Committee on MS Registry, a self-reported patient group, to participate in this study. In spring of 2020, participants responded to questions about demographics and opinions about vaccination.

Out of the 10,210 individuals contacted, 62.5% (N=6385) responded. Those who chose to participate were more likely to be White (86.7% vs 82.6%, respectively; P <.001) women (80.9% vs 78.7%, respectively; P =.009), older (62 vs 59 years, respectively), and more likely to have had a higher level of postsecondary education (72.7% vs 68.9%; P <.001).

A total of 5244 responders met the inclusion criteria. This study population had an average age of 61.8 (standard deviation [SD], 10.1) years, 80.8% were women, and 87.4% were White.

Participants indicated they had received a vaccination for tetanus (88.5%), that season’s influenza (74.1%), measles, mumps, rubella (74.1%), pneumonia (61.2%), varicella (42.1%), herpes zoster (41.2%), and hepatitis B (32.3%) and A (22.0%).

Vaccination during the recent influenza season was more likely among patients who earned more than $100,000 annually (odds ratio [OR], 1.44; 95% CI, 1.16-1.79), used any disease-modifying therapy (OR, 1.41; 95% CI, 1.23-1.63), had postsecondary education (OR, 1.26; 95% CI, 1.08-1.47), consumed alcohol 2 to 4 times per month (OR, 1.26; 95% CI, 1.02-1.56), and had an active lifestyle (OR, 1.22; 95% CI, 1.05-1.42).

Fewer individuals received the influenza vaccine who smoked (OR, 0.60; 95% CI, 0.47-0.77) or were younger (age 18-34 years: OR, 0.29; 95% CI, 0.14-0.60; 35-49 years: OR, 0.35; 95% CI, 0.27-0.45; 50-64 years: OR, 0.57; 95% CI, 0.49-0.66).

Common motivations for not being vaccinated against influenza that season (n=1303) included personal preference (30.0%; eg, no need for vaccine), side effects or previous illness following vaccine (29.3%), concerns about worsening MS symptoms (23.6%), because their doctor advised against vaccination (12.1%), or contextual factors (9.29%; eg, too busy, was not offered).

Perceptions about who was responsible for determining which vaccines they should receive varied. Although most thought they themselves were responsible (66.9%), 57.9% also thought their primary care provider and 41.2% thought their neurologists was at least, in part, responsible for their vaccination status.

Participants said they had been advised to avoid Herpes Zoster (n=362), influenza nasal mist vaccine (n=287), other (273), influenza shot (n=132), pneumonia (n=76), varicella (n=48), measles, mumps, rubella (n=39), hepatitis (n=24), and tetanus (n=14) vaccines.

This study may have been limited by the statistical differences between responders and nonresponders.

These data indicated that vaccine uptake was less than optimal among the MS patient population with relatively high amounts of circulating misinformation. Clinicians should be aware of these trends and prioritize appropriate and accurate education among their patients.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


Marrie RA, Kosowan L, Cutter GR, Fox R, Salter A. Uptake and Attitudes About Immunizations in People With Multiple Sclerosis. Neuro Clin Pract. Published online April 22, 2021. doi:10.1212/CPJ.0000000000001099