Schade Paula, Nguyen Hai-Anh, Steinle Julia, Hellwig Kerstin, Pelea Teodor, Franken Philipp, Elias-Hamp Birte, Becker Veit, Merkelbach Stefan, Richter Stephan, Wagner Bert, Geis Christian, Schwab Matthias, Rakers Florian
Department of Neurology, Jena University Hospital, Jena, Germany.
Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany.
Ther Adv Neurol Disord. 2025 Jan 24;18:17562864241309806. doi: 10.1177/17562864241309806. eCollection 2025.
Complete vaccination coverage is recommended by multiple sclerosis (MS) societies for patients with multiple sclerosis (pwMS) to mitigate infection risks associated with disease-modifying therapies (DMTs).
To analyze vaccination coverage and its determinants in pwMS compared to healthy controls, considering vaccination hesitancy, MS-specific vaccination beliefs, trust in information sources, and the role of general practitioners (GPs).
This cross-sectional multicenter observational study was conducted in six German MS centers. The primary endpoint was a vaccination index (VI) comprising eight standard vaccinations (range 0-1, with higher VI indicating better vaccination coverage). Secondary endpoints included validated measures of general vaccination hesitancy, MS-specific vaccination beliefs, and trust in information sources. Data were collected through questionnaires, vaccination card analysis, and a survey of GPs who vaccinate pwMS.
VI tended to be lower in pwMS ( = 397) compared to healthy controls ( = 300; 0.58 ± 0.30 vs 0.62 ± 0.31, = 0.057). In pwMS receiving highly effective DMTs, VI did not differ significantly from those on no/platform DMTs. Vaccination hesitancy was comparably low, with no differences between pwMS and controls. Vaccination hesitancy, beliefs, and trust in information sources explained only 10%-16% of the variance in VI. Among 109 GPs, 82% cited reluctance to vaccinate pwMS due to concerns about MS-related side effects or interactions with DMTs.
Despite clear recommendations from MS societies for full vaccination of all pwMS, vaccination coverage remains worryingly low. Approximately half of the patients lack standard vaccination coverage, even those on highly effective DMTs. In fact, vaccination coverage in pwMS tended to be even lower than in healthy controls. Vaccination hesitancy and other intrinsic factors do not sufficiently explain the low vaccination rates. Inconsistent vaccination recommendations from GPs due to uncertainties about vaccine safety and DMT interactions likely contribute.
多发性硬化症（MS）协会建议为多发性硬化症患者（pwMS）提供全面的疫苗接种，以降低与疾病修饰疗法（DMT）相关的感染风险。
与健康对照相比，分析pwMS的疫苗接种覆盖率及其决定因素，同时考虑疫苗接种犹豫、MS特异性疫苗接种信念、对信息来源的信任以及全科医生（GP）的作用。
这项横断面多中心观察性研究在六个德国MS中心进行。主要终点是一个疫苗接种指数（VI），包括八种标准疫苗接种（范围为0 - 1，VI越高表明疫苗接种覆盖率越好）。次要终点包括对一般疫苗接种犹豫、MS特异性疫苗接种信念以及对信息来源信任的有效测量。数据通过问卷调查、疫苗接种卡分析以及对为pwMS接种疫苗的全科医生的调查收集。
与健康对照（n = 300）相比，pwMS（n = 397）的VI往往较低（0.58 ± 0.30 vs 0.62 ± 0.31，P = 0.057）。在接受高效DMT的pwMS中，VI与未接受/接受平台DMT的患者相比无显著差异。疫苗接种犹豫程度相对较低，pwMS与对照组之间无差异。疫苗接种犹豫、信念以及对信息来源的信任仅解释了VI变异的10% - 16%。在109名全科医生中，82%表示由于担心与MS相关的副作用或与DMT的相互作用而不愿为pwMS接种疫苗。
尽管MS协会明确建议所有pwMS进行全面疫苗接种，但疫苗接种覆盖率仍然低得令人担忧。大约一半的患者缺乏标准疫苗接种覆盖率，即使是那些接受高效DMT的患者。事实上，pwMS的疫苗接种覆盖率往往比健康对照还要低。疫苗接种犹豫和其他内在因素不足以解释低接种率。由于疫苗安全性和DMT相互作用的不确定性，全科医生的疫苗接种建议不一致可能是原因之一。
