Clinical Edge

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Vaccination Not Associated With Increased Risk of MS

Key clinical point: Data do not support an association between vaccination and increased risk of MS.

Major finding: The odds of MS were lower in participants who received vaccination, compared with participants without autoimmune disease (odds ratio, 0.870).

Study details: A systematic retrospective analysis of claims data for 12,262 patients with MS and 210,773 controls.

Disclosures: A grant from the German Federal Ministry of Education and Research Competence Network MS supported the study. The authors had no relevant conflicts.


Hapfelmeier A et al. Neurology. 2019 Jul 30. doi: 10.1212/WNL.0000000000008012.


The analysis by Hapfelmeier et al. provides important evidence that vaccinations are not associated with multiple sclerosis (MS), said E. Ann Yeh, MD, a neurologist at the Hospital for Sick Children in Toronto, and Jennifer Graves, MD, PhD, a neurologist at the University of California, San Diego, in an accompanying editorial. On the contrary, the evidence supports a potential protective effect of vaccines on the risk of developing MS, they said.

“The reasons for this [finding] cannot be gleaned from this study and may range from biological to sociocultural/demographic reasons,” the authors added. “Infection, rather than vaccination, may be an MS trigger, or individuals obtaining vaccinations may be practicing other healthy behaviors protective for MS. These possibilities should be the subject of future studies.”

Until future studies are completed and their results published, the findings of Hapfelmeier et al. offer “strong evidence to share with worried patients and families when faced with the question of whether a vaccine in the recent or relatively distant past triggered the individual’s MS,” said Dr. Yeh and Dr. Graves.

The authors had various relationships with industry, including serving on advisory boards for and receiving funding from pharmaceutical companies.