Multiple sclerosis (MS) is a condition where your immune system attacks the protective myelin that coats nerve cells in your brain and spinal cord. It can lead to symptoms such as numbness and tingling, muscle weakness, and vision problems.

If you have MS, you may have questions about getting vaccines. It’s possible you may be concerned that your MS medications may make vaccines less effective or that vaccines could make your MS symptoms worse.

In this article, we cover whether or not you should get the Tdap vaccine if you have MS, general vaccine recommendations for people with MS, and precautions to be aware of.

Most people with MS use disease-modifying therapies (DMTs). These are medications that dampen the effects of your immune system, helping to lower MS disease activity.

Because DMTs suppress your immune system, people with MS can be more vulnerable to infections. Contracting an infection can also trigger an MS flare. Because of this, vaccination is important for people with MS.

The Tdap vaccine protects against three potentially serious bacterial illnesses:

  • Tetanus (T): Tetanus, or lockjaw, causes painful stiffening of muscles throughout your body.
  • Diphtheria (d): Diphtheria leads to a membrane-like coating in your throat that can interfere with your breathing.
  • Pertussis (aP): Pertussis, which is also called whooping cough, can cause violent coughing fits that make it difficult to do things such as breathe, drink, or eat.

It’s OK to get the Tdap vaccine if you have MS. In fact, the American Academy of Neurology (AAN) recommends that people with MS follow standard vaccine guidelines unless there’s a specific reason not to (contraindication).

Potential side effects

The side effects of the Tdap vaccine are similar to those of many other vaccines and can include:

Will vaccinations increase the risk of an MS flare?

The AAN guidelines say that there’s no evidence that vaccination increases the risk of an MS flare. But they also note that studies in this area are still limited.

It’s still important to talk with a doctor or healthcare professional before getting any vaccine, including the Tdap vaccine. They can look at your medical history as well as the types of MS medications you’re taking and recommend a timeline for getting your vaccine.

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As we noted earlier, the AAN guidelines recommend that people with MS follow standard vaccine guidelines unless there’s a specific contraindication.

The chart below shows the current vaccine recommendations for adults in the United States, according to the Centers for Disease Control and Prevention (CDC).

VaccineWhen it’s givenHow it’s givenOther details to be aware of
Influenza (flu), inactivated or recombinantall ages1 dose annually
Coronavirus disease 19 (COVID-19)all agesThe up-to-date COVID-19 vaccine schedule can be found here.messenger RNA vaccines preferred
Tdap or tetanus and diphtheria (Td)all ages1 dose Tdap, then Tdap or Td booster every 10 yearsinitial Tdap dose often given in childhood
Measles mumps rubellaages 19–65 years1 or 2 dosesoften given in childhood
Varicella (chickenpox)all ages2 dosesoften given in childhood
Shinglesages 50 years and older2 doses
Human papillomavirusages 19–26 years2 or 3 dosesoften given in adolescence, but can be given to those ages 27 to 45 after consulting with a doctor
Hepatitis Bages 19–59 years2 or 3 dosesoften given in childhood
Pneumococcal vaccineages 65 years and older1 or 2 doseseither 1 dose 15-valent pneumococcal conjugate vaccine (PCV) followed by 23-valent pneumococcal conjugate vaccine or 1 dose PCV20
Hepatitis Aall ages2 or 3 dosesrecommended for travel to areas where hepatitis A is common
Meningococcal vaccineall ages1 or 2 dosesrecommended for travel to areas where meningococcal disease is common

It’s important to be aware of your MS medications when scheduling your vaccinations. This is because people with MS that are using DMTs can have a weakened immune system.

Due to this, live-attenuated vaccines aren’t typically given while you’re on DMTs. Live vaccines contain a weakened form of a germ, but because the germ is still live, they can potentially cause problems for people with a weak immune system.

Live-attenuated vaccines include the:

Additionally, some DMTs may lower the effectiveness of certain vaccines. As such, discuss your MS medications with a doctor prior to scheduling vaccinations. They can recommend an optimal timeframe for them.

Now let’s examine the answers to some remaining questions that you may have about MS and vaccines.

Should you delay getting a vaccine if you’re having an MS flare?

Yes. Both the AAN guidelines and the National MS Society recommend delaying vaccination if you’re having an MS flare.

You should wait to receive your vaccination until your symptoms have gone away or are no longer getting worse.

Which COVID-19 vaccine is best if you have MS?

Although the CDC says that you may choose any of the three coronavirus disease 19 (COVID-19) vaccines in use in the United States, they note that messenger RNA (mRNA) vaccines are preferred over the Johnson & Johnson (J&J) adenoviral vector vaccine.

This recommendation was made after a review of the data on the safety and effectiveness of the J&J vaccine. Overall, the mRNA vaccines have a better safety profile and are more effective than the J&J vaccine.

mRNA vaccines are those produced by Pfizer-BioNTech and Moderna.

Are there any vaccines linked to MS?

Some may have concerns that vaccination may act as a trigger for MS. But recent studies, such as this 2019 study, have found that vaccines aren’t associated with an increased risk of developing MS.

In fact, some vaccines may have a protective effect against MS. A 2021 review notes that several studies have found that receiving a tetanus vaccination, which is included in the Tdap vaccine, is associated with a decreased risk of MS.

The Tdap vaccine protects against three different bacterial infections that can be potentially serious. People with MS can receive the Tdap vaccine.

DMTs that are used to treat MS can weaken your immune system and make people with MS more vulnerable to infections. And infections are a potential trigger for MS flares.

This makes vaccination important for people with MS. The AAN recommends that people with MS stick to a standard vaccination schedule unless there are specific contraindications.

Consult with a doctor prior to scheduling vaccine appointments. They can review your medical history and MS medications to let you know which vaccines are recommended as well as the best timeframe to get them in.