Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and abnormal fatigability due to the antibodies against postsynaptic receptors. Despite the individual discrepancy, patients with MG share common muscle weakness, autoimmune dysfunction, and immunosuppressive treatment, which predispose them to infections that can trigger or exacerbate MG. Vaccination, as a mainstay of prophylaxis, is a major management strategy. However, the past years have seen growth in vaccine hesitancy, owing to safety and efficacy concerns. Ironically, vaccines, serving as an essential and effective means of defense, may induce similar immune cross-reactivity to what they are meant to prevent. Herein, we outline the progress in vaccination, review the current status, and postulate the clinical association among MG, vaccination, and immunosuppression. We also address safety and efficacy concerns of vaccination in MG, in relation to COVID-19. Since only a handful of studies have reported vaccination in individuals with MG, we further review the current clinical studies and guidelines in rheumatic diseases. Overall, our reviews offer a reference to guide future vaccine clinical decision-making and improve the management of MG patients.

重症肌无力 (MG) 是一种自身免疫性疾病，其特征是由于突触后受体抗体导致肌肉无力和异常疲劳。尽管存在个体差异，但 MG 患者都有共同的肌肉无力、自身免疫功能障碍和免疫抑制治疗，这使他们容易受到可能引发或加重 MG 的感染。疫苗接种作为预防的主要手段，是一项主要的管理策略。然而，过去几年，出于对安全性和有效性的担忧，人们对疫苗的犹豫有所增加。具有讽刺意味的是，疫苗作为一种重要且有效的防御手段，可能会诱导与其本应预防的情况类似的免疫交叉反应。在此，我们概述了疫苗接种的进展，回顾了现状，并假设了 MG、疫苗接种和免疫抑制之间的临床关联。我们还解决了与 COVID-19 相关的 MG 疫苗接种的安全性和有效性问题。由于只有少数研究报告了 MG 患者的疫苗接种情况，我们进一步回顾了当前风湿性疾病的临床研究和指南。总体而言，我们的综述为指导未来疫苗临床决策和改善 MG 患者的管理提供了参考。