Servicio de Medicina Preventiva, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España; Centro de Esclerosis Múltiple de Catalunya (Cemcat), Departamento de Neurología/Neuroimmunología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
Servicio de Medicina Preventiva, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España.
Neurologia (Engl Ed). 2021 Jan-Feb;36(1):50-60. doi: 10.1016/j.nrl.2020.02.006. Epub 2020 Jun 17.
The recent development of highly effective treatments for multiple sclerosis (MS) and the potential risk of infectious complications require the development of prevention and risk minimisation strategies. Vaccination is an essential element of the management of these patients. This consensus statement includes a series of recommendations and practical scenarios for the vaccination of adult patients with MS who are eligible for highly effective immunosuppressive treatments.
A formal consensus procedure was followed. Having defined the scope of the statement, we conducted a literature search on recommendations for the vaccination of patients with MS and specific vaccination guidelines for immunosuppressed patients receiving biological therapy for other conditions. The modified nominal group technique methodology was used to formulate the recommendations.
Vaccination in patients who are candidates for immunosuppressive therapy should be considered before starting immunosuppressive treatment providing the patient's clinical situation allows. Vaccines included in the routine adult vaccination schedule, as well as some specific ones, are recommended depending on the pre-existing immunity status. If immunosuppressive treatment is already established, live attenuated vaccines are contraindicated. For vaccines with a correlate of protection, it is recommended to monitor the serological response in an optimal interval of 1-2 months from the last dose.
多发性硬化症（MS）高效治疗方法的最新发展以及感染性并发症的潜在风险，要求制定预防和降低风险策略。疫苗接种是管理这些患者的重要手段。本共识声明包含一系列针对符合高效免疫抑制治疗条件的成年 MS 患者的疫苗接种建议和实用方案。
采用正式的共识程序。在确定声明范围后，我们对 MS 患者疫苗接种建议以及接受其他适应证生物治疗的免疫抑制患者特定疫苗接种指南进行了文献检索。采用改良名义群体技术方法制定建议。
对于有资格接受免疫抑制治疗的患者，应在开始免疫抑制治疗前考虑疫苗接种，前提是患者的临床状况允许。根据既往免疫状况推荐常规成人疫苗接种方案中的疫苗以及一些特定疫苗。对于减毒活疫苗，禁忌用于已经接受免疫抑制治疗的患者。对于具有保护相关性的疫苗，建议在最后一剂后 1-2 个月的最佳间隔内监测血清学反应。
