Vaccinations With Multiple Sclerosis
General Vaccine Information
- Before receiving any vaccine, talk with your healthcare provider about any MS medicine you are using.
- People with MS should receive vaccines according to standard vaccine guidelines.
- Preventing infections through vaccine use is a key part of medical care for people with MS.
Experts from the American Academy of Neurology (AAN) reviewed the available scientific evidence on infections and vaccine use in MS and made recommendations in this Practice Guideline: Infections and Vaccine Use in Multiple Sclerosis.Here are some key messages and takeaways from the guideline:
- Before receiving any vaccine, talk with your healthcare provider about any MS medicine you are using.
- People with MS should receive vaccines according to standard vaccine guidelines.
- Preventing infections through vaccine use is a key part of medical care for people with MS.
Vaccine Use in MS
medication guide.
Consider the following before receiving a vaccination:
- Live-attenuated vaccines are not recommended for people with MS who have recently taken steroids or who take certain disease-modifying therapies (DMTs) that suppress the immune system.
- People who are experiencing a relapse should delay vaccination until the relapse symptoms are no longer worsening or have resolved.
- Prior to starting any DMT, talk with your healthcare provider about any vaccines you should get or have recently received. Vaccination considerations specific to each DMT can be found in the medication guide.
The composition of U.S. influenza (flu) vaccines is reviewed annually by the CDC and updated each year to match circulating flu viruses.
- The CDC recommends everyone 6 months of age and older, with rare exceptions, receive an updated 2025-2026 flu vaccine.
- The CDC has determined it is safe for you to get the influenza vaccine and other vaccines at the same time as the COVID-19 vaccine.
- The AAN recommends that people with MS receive the annual influenza vaccine unless they have a specific reason they cannot get it.
- The AAN recommends against using live-attenuated vaccines (e.g., FluMist nasal spray) in people with MS who are currently taking a DMT. For some DMTs, there are also restrictions from the U.S. Food and Drug Administration (FDA) on the timing of a live-attenuated vaccine after discontinuing a DMT. Prior to receiving a live-attenuated vaccine, discuss the risks, benefits and appropriate timing with your MS healthcare provider.
- Pregnant and postpartum women are at higher risk for severe illness and complications from influenza. Getting vaccinated while pregnant can help protect your baby from the flu after birth. Read more on the American College of Obstetricians and Gynecologists website and work with your healthcare provider on what vaccines you should receive during pregnancy.
- September and October are the best times for most people to get vaccinated.
Vaccination against COVID-19 is critical for public safety and especially the safety of those who are immunocompromised. Review our guidance to learn more about COVID-19 vaccines and MS.Hepatitis B Vaccine
The CDC maintains guidelines for hepatitis B vaccination that differ by age and other factors. Discuss with your healthcare provider if hepatitis B vaccination is right for you.A 2021 review of hepatitis B vaccination studies in MS concluded that the hepatitis B vaccine does not increase a person's risk of developing MS.Human Papillomavirus (HPV) Vaccine (Gardasil®)
This vaccine is designed to prevent cervical cancer, dysplasias (pre-cancer cells) in the cervix, vulva and vagina, and condyloma acuminate (also known as genital warts) related to certain types of the human papillomavirus in females ages 9 to 26. The MS DMTs affect how your immune system works throughout the body and the way your immune system clears infections, including HPV. Before starting any MS DMTs, talk to your healthcare provider about receiving the HPV vaccine.A large-scale study of patient registries in Denmark and Sweden found no increased risk of developing MS among nearly 800,000 people who received this vaccine.Measles, Mumps, and Rubella (MMR) Vaccine
The CDC considers most people protected for life and not needing a booster dose if they have had two doses of the MMR vaccine (per the U.S. standard vaccine schedule) or were born after 1957 and received one dose. See the CDC’s measles protection guidance for more information. The MMR vaccine is a live attenuated vaccine. This type of vaccine is not recommended for people with MS who have recently taken steroids or who take certain disease modifying therapies (DMTs) that suppress the immune system. If you are not sure if you are fully vaccinated against measles, talk with your healthcare team.Mpox (Monkeypox)
The CDC recommends the JYNNEOS vaccine for people who have been exposed to mpox or who may be more likely to get mpox, even if they have a weakened immune system.Vaccination with JYNNEOS is safe for people with MS, including those who are immunocompromised. While the ACAM2000 vaccine is also available, this vaccine should be avoided by people with MS.Pneumococcal (Pneumonia) Vaccines
There are four pneumococcal vaccines (Prevnar 13®, Vaxneuvance®, Prevnar 20® and Pneumovax23®). Which vaccine is given is determined by age or other factors.Pneumococcal vaccines are inactivated. Inactivated vaccines are considered safe for people with MS.According to the AAN’s recommendations on immunizations for people with MS, pneumococcal vaccines should be considered for individuals with compromised pulmonary function, including those who use a wheelchair on a full-time basis or are bed-bound.Respiratory Syncytial Virus (RSV) Vaccines (Abrysvo™, Arexvy®, mRESVIA®)
The RSV vaccines protect against respiratory syncytial virus, which can cause a variety of respiratory illnesses and symptoms.
- The CDC recommends adults 75 years and older receive a single dose of the RSV vaccine. Adults 60 to 74 years of age who are at increased risk of severe RSV disease should also receive a single dose of the RSV vaccine.
- People 60 to 74 years of age who are at increased risk of severe RSV disease include those with certain chronic medical conditions, such as lung or heart disease, people who are immunocompromised or are taking DMTs that suppress the immune system or those living in nursing homes.
- The RSV vaccine may be given at the same time as other vaccines.
- Eligible adults can get an RSV vaccine at any time, but the best time to get vaccinated is in late summer and early fall before RSV usually starts to spread in communities.
- The RSV vaccine is not currently an annual vaccine, meaning people only need a single dose and do not need to get a booster dose every RSV season.
The CDC recommends Shingrix, an inactivated vaccine for the prevention of herpes zoster (shingles) and related complications. Shingrix is approved for adults 50 years and older.People who are age 19 or older and taking certain MS medications should receive a Shingrix vaccine. It is important to discuss this vaccine with your MS healthcare provider.One study of Shingrix in the older MS population has shown that Shingrix is moderately to very effective in preventing zoster attacks.Smallpox Vaccine
While this vaccine has not been studied in people with MS, it should be made available to any person with MS directly exposed to smallpox, as the risks associated with not getting vaccinated would be too great.Varicella (Chicken Pox) Vaccine
This vaccine should be considered by people with MS who have never had chicken pox, lack evidence of prior immunity, and are considering starting certain MS medications. After getting the vaccine, the length of time you will have to wait before starting MS medications varies. Talk to your healthcare provider to learn more about the waiting period." c-nmssatomrichtext_nmssatomrichtext-host="">
Seasonal Flu Vaccine
The composition of U.S. influenza (flu) vaccines is reviewed annually by the CDC and updated each year to match circulating flu viruses.
Vaccination against COVID-19 is critical for public safety and especially the safety of those who are immunocompromised. Review our guidance to learn more about COVID-19 vaccines and MS.Hepatitis B Vaccine
The CDC maintains guidelines for hepatitis B vaccination that differ by age and other factors. Discuss with your healthcare provider if hepatitis B vaccination is right for you.A 2021 review of hepatitis B vaccination studies in MS concluded that the hepatitis B vaccine does not increase a person's risk of developing MS.Human Papillomavirus (HPV) Vaccine (Gardasil®)
This vaccine is designed to prevent cervical cancer, dysplasias (pre-cancer cells) in the cervix, vulva and vagina, and condyloma acuminate (also known as genital warts) related to certain types of the human papillomavirus in females ages 9 to 26. The MS DMTs affect how your immune system works throughout the body and the way your immune system clears infections, including HPV. Before starting any MS DMTs, talk to your healthcare provider about receiving the HPV vaccine.A large-scale study of patient registries in Denmark and Sweden found no increased risk of developing MS among nearly 800,000 people who received this vaccine.Measles, Mumps, and Rubella (MMR) Vaccine
The CDC considers most people protected for life and not needing a booster dose if they have had two doses of the MMR vaccine (per the U.S. standard vaccine schedule) or were born after 1957 and received one dose. See the CDC’s measles protection guidance for more information. The MMR vaccine is a live attenuated vaccine. This type of vaccine is not recommended for people with MS who have recently taken steroids or who take certain disease modifying therapies (DMTs) that suppress the immune system. If you are not sure if you are fully vaccinated against measles, talk with your healthcare team.Mpox (Monkeypox)
The CDC recommends the JYNNEOS vaccine for people who have been exposed to mpox or who may be more likely to get mpox, even if they have a weakened immune system.Vaccination with JYNNEOS is safe for people with MS, including those who are immunocompromised. While the ACAM2000 vaccine is also available, this vaccine should be avoided by people with MS.Pneumococcal (Pneumonia) Vaccines
There are four pneumococcal vaccines (Prevnar 13®, Vaxneuvance®, Prevnar 20® and Pneumovax23®). Which vaccine is given is determined by age or other factors.Pneumococcal vaccines are inactivated. Inactivated vaccines are considered safe for people with MS.According to the AAN’s recommendations on immunizations for people with MS, pneumococcal vaccines should be considered for individuals with compromised pulmonary function, including those who use a wheelchair on a full-time basis or are bed-bound.Respiratory Syncytial Virus (RSV) Vaccines (Abrysvo™, Arexvy®, mRESVIA®)
The RSV vaccines protect against respiratory syncytial virus, which can cause a variety of respiratory illnesses and symptoms.
The CDC recommends Shingrix, an inactivated vaccine for the prevention of herpes zoster (shingles) and related complications. Shingrix is approved for adults 50 years and older.People who are age 19 or older and taking certain MS medications should receive a Shingrix vaccine. It is important to discuss this vaccine with your MS healthcare provider.One study of Shingrix in the older MS population has shown that Shingrix is moderately to very effective in preventing zoster attacks.Smallpox Vaccine
While this vaccine has not been studied in people with MS, it should be made available to any person with MS directly exposed to smallpox, as the risks associated with not getting vaccinated would be too great.Varicella (Chicken Pox) Vaccine
This vaccine should be considered by people with MS who have never had chicken pox, lack evidence of prior immunity, and are considering starting certain MS medications. After getting the vaccine, the length of time you will have to wait before starting MS medications varies. Talk to your healthcare provider to learn more about the waiting period.
The composition of U.S. influenza (flu) vaccines is reviewed annually by the CDC and updated each year to match circulating flu viruses.
- The CDC recommends everyone 6 months of age and older, with rare exceptions, receive an updated 2025-2026 flu vaccine.
- The CDC has determined it is safe for you to get the influenza vaccine and other vaccines at the same time as the COVID-19 vaccine.
- The AAN recommends that people with MS receive the annual influenza vaccine unless they have a specific reason they cannot get it.
- The AAN recommends against using live-attenuated vaccines (e.g., FluMist nasal spray) in people with MS who are currently taking a DMT. For some DMTs, there are also restrictions from the U.S. Food and Drug Administration (FDA) on the timing of a live-attenuated vaccine after discontinuing a DMT. Prior to receiving a live-attenuated vaccine, discuss the risks, benefits and appropriate timing with your MS healthcare provider.
- Pregnant and postpartum women are at higher risk for severe illness and complications from influenza. Getting vaccinated while pregnant can help protect your baby from the flu after birth. Read more on the American College of Obstetricians and Gynecologists website and work with your healthcare provider on what vaccines you should receive during pregnancy.
- September and October are the best times for most people to get vaccinated.
Vaccination against COVID-19 is critical for public safety and especially the safety of those who are immunocompromised. Review our guidance to learn more about COVID-19 vaccines and MS.Hepatitis B Vaccine
The CDC maintains guidelines for hepatitis B vaccination that differ by age and other factors. Discuss with your healthcare provider if hepatitis B vaccination is right for you.A 2021 review of hepatitis B vaccination studies in MS concluded that the hepatitis B vaccine does not increase a person's risk of developing MS.Human Papillomavirus (HPV) Vaccine (Gardasil®)
This vaccine is designed to prevent cervical cancer, dysplasias (pre-cancer cells) in the cervix, vulva and vagina, and condyloma acuminate (also known as genital warts) related to certain types of the human papillomavirus in females ages 9 to 26. The MS DMTs affect how your immune system works throughout the body and the way your immune system clears infections, including HPV. Before starting any MS DMTs, talk to your healthcare provider about receiving the HPV vaccine.A large-scale study of patient registries in Denmark and Sweden found no increased risk of developing MS among nearly 800,000 people who received this vaccine.Measles, Mumps, and Rubella (MMR) Vaccine
The CDC considers most people protected for life and not needing a booster dose if they have had two doses of the MMR vaccine (per the U.S. standard vaccine schedule) or were born after 1957 and received one dose. See the CDC’s measles protection guidance for more information. The MMR vaccine is a live attenuated vaccine. This type of vaccine is not recommended for people with MS who have recently taken steroids or who take certain disease modifying therapies (DMTs) that suppress the immune system. If you are not sure if you are fully vaccinated against measles, talk with your healthcare team.Mpox (Monkeypox)
The CDC recommends the JYNNEOS vaccine for people who have been exposed to mpox or who may be more likely to get mpox, even if they have a weakened immune system.Vaccination with JYNNEOS is safe for people with MS, including those who are immunocompromised. While the ACAM2000 vaccine is also available, this vaccine should be avoided by people with MS.Pneumococcal (Pneumonia) Vaccines
There are four pneumococcal vaccines (Prevnar 13®, Vaxneuvance®, Prevnar 20® and Pneumovax23®). Which vaccine is given is determined by age or other factors.Pneumococcal vaccines are inactivated. Inactivated vaccines are considered safe for people with MS.According to the AAN’s recommendations on immunizations for people with MS, pneumococcal vaccines should be considered for individuals with compromised pulmonary function, including those who use a wheelchair on a full-time basis or are bed-bound.Respiratory Syncytial Virus (RSV) Vaccines (Abrysvo™, Arexvy®, mRESVIA®)
The RSV vaccines protect against respiratory syncytial virus, which can cause a variety of respiratory illnesses and symptoms.
- The CDC recommends adults 75 years and older receive a single dose of the RSV vaccine. Adults 60 to 74 years of age who are at increased risk of severe RSV disease should also receive a single dose of the RSV vaccine.
- People 60 to 74 years of age who are at increased risk of severe RSV disease include those with certain chronic medical conditions, such as lung or heart disease, people who are immunocompromised or are taking DMTs that suppress the immune system or those living in nursing homes.
- The RSV vaccine may be given at the same time as other vaccines.
- Eligible adults can get an RSV vaccine at any time, but the best time to get vaccinated is in late summer and early fall before RSV usually starts to spread in communities.
- The RSV vaccine is not currently an annual vaccine, meaning people only need a single dose and do not need to get a booster dose every RSV season.
The CDC recommends Shingrix, an inactivated vaccine for the prevention of herpes zoster (shingles) and related complications. Shingrix is approved for adults 50 years and older.People who are age 19 or older and taking certain MS medications should receive a Shingrix vaccine. It is important to discuss this vaccine with your MS healthcare provider.One study of Shingrix in the older MS population has shown that Shingrix is moderately to very effective in preventing zoster attacks.Smallpox Vaccine
While this vaccine has not been studied in people with MS, it should be made available to any person with MS directly exposed to smallpox, as the risks associated with not getting vaccinated would be too great.Varicella (Chicken Pox) Vaccine
This vaccine should be considered by people with MS who have never had chicken pox, lack evidence of prior immunity, and are considering starting certain MS medications. After getting the vaccine, the length of time you will have to wait before starting MS medications varies. Talk to your healthcare provider to learn more about the waiting period.