BACKGROUND Patients with multiple sclerosis (MS) are at increased risk of infection. Vaccination can mitigate these risks but only if safe and effective in MS patients, including those taking disease-modifying drugs. METHODS A modified Delphi consensus process (October 2017-June 2018) was used to develop clinically relevant recommendations for making decisions about vaccinations in patients with MS. A series of statements and recommendations regarding the efficacy, safety and timing of vaccine administration in patients with MS were generated in April 2018 by a panel of experts based on a review of the published literature performed in October 2017. RESULTS Recommendations include the need for an 'infectious diseases card' of each patient's infectious and immunisation history at diagnosis in order to exclude and eventually treat latent infections. We suggest the implementation of the locally recommended vaccinations, if possible at MS diagnosis, otherwise with vaccination timing tailored to the planned/current MS treatment, and yearly administration of the seasonal influenza vaccine regardless of the treatment received. CONCLUSION Patients with MS should be vaccinated with careful consideration of risks and benefits. However, there is an urgent need for more research into vaccinations in patients with MS to guide evidence-based decision making.

中文翻译：

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多发性硬化患者的疫苗接种：德尔福共识声明

背景多发性硬化症（MS）患者感染的风险增加。疫苗接种可以减轻这些风险，但前提是对 MS 患者（包括服用改善病情药物的患者）安全有效。方法 修改后的 Delphi 共识程序（2017 年 10 月至 2018 年 6 月）用于制定临床相关建议，以制定 MS 患者的疫苗接种决策。2018 年 4 月，专家小组根据对 2017 年 10 月发表的文献的审查，提出了一系列关于 MS 患者疫苗接种的有效性、安全性和时机的声明和建议。结果 建议包括需要每位患者的“传染病卡” s 传染和免疫历史在诊断为了排除和最终治疗潜伏感染。我们建议实施当地推荐的疫苗接种，如果可能的话在 MS 诊断时进行，否则根据计划/当前的 MS 治疗定制疫苗接种时间，并且无论接受何种治疗，每年接种季节性流感疫苗。结论 MS 患者应在仔细考虑风险和收益的情况下接种疫苗。然而，迫切需要对 MS 患者的疫苗接种进行更多研究，以指导循证决策。无论接受何种治疗，每年都会接种季节性流感疫苗。结论 MS 患者应在仔细考虑风险和收益的情况下接种疫苗。然而，迫切需要对 MS 患者的疫苗接种进行更多研究，以指导循证决策。无论接受何种治疗，每年都会接种季节性流感疫苗。结论 MS 患者应在仔细考虑风险和收益的情况下接种疫苗。然而，迫切需要对 MS 患者的疫苗接种进行更多研究，以指导循证决策。