Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Bavarian Association of Statutory Health Insurance Physicians, Munich, Germany.
Mult Scler. 2023 Dec;29(14):1831-1840. doi: 10.1177/13524585231199084. Epub 2023 Oct 13.
Infections are discussed as risk factor for multiple sclerosis (MS) development and relapses. This may lead to decreased vaccination frequency in newly diagnosed patients.
The aim of this study was to evaluate the relation of MS diagnosis to subsequent vaccination frequency.
Based on German ambulatory claims data from 2005 to 2019, regression models were used to assess the relation of MS diagnosis ( = 12,270) to vaccination. A cohort of patients with MS was compared to control cohorts with Crohn's disease, psoriasis, and without these autoimmune diseases (total = 198,126) in the 5 years after and before diagnosis.
Patients with MS were less likely to be vaccinated compared to persons without the autoimmune diseases 5 years after diagnosis (odds ratio = 0.91, < 0.001). Exceptions were vaccinations against influenza (1.29, < 0.001) and pneumococci (1.41, < 0.001). Differences were strong but less pronounced after than before diagnosis ( < 0.001). The likelihood of vaccination was also lower compared to patients with Crohn's disease or psoriasis.
Patients with MS were not adequately vaccinated despite guideline recommendations. Increasing awareness about the importance of vaccination is warranted to reduce the risk of infection, in particular, in patients with MS receiving immunotherapies.
感染被认为是多发性硬化症（MS）发展和复发的危险因素。这可能导致新诊断患者的疫苗接种频率降低。
本研究旨在评估 MS 诊断与随后疫苗接种频率之间的关系。
基于 2005 年至 2019 年德国门诊索赔数据，使用回归模型评估 MS 诊断（= 12,270）与疫苗接种的关系。将 MS 患者队列与克罗恩病、银屑病和无自身免疫性疾病的对照队列（总= 198,126）在诊断后 5 年和诊断前 5 年进行比较。
与无自身免疫性疾病的患者相比，MS 患者在诊断后 5 年内接种疫苗的可能性较低（优势比= 0.91， < 0.001）。流感（1.29， < 0.001）和肺炎球菌（1.41， < 0.001）疫苗接种除外。诊断后（<0.001）比诊断前差异更强但程度较轻。与克罗恩病或银屑病患者相比，接种疫苗的可能性也较低。
尽管有指南建议，但 MS 患者的疫苗接种并不充分。需要提高对疫苗接种重要性的认识，以降低感染风险，特别是在接受免疫疗法的 MS 患者中。
