Hello all:
Since we have been talking about the flu maybe this article will show
some
light on the subject.
Roger
http://www.nmss.org/msinfo/current_research/updates/rmp9723d.html
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Controversy has long surrounded the question of whether to administer influenza vaccine to persons with MS. Illnesses like influenza, which are caused by viruses and can produce fever, may precipitate an attack (exacerbation, or acute period of worsening) of MS. It is thus desirable to prevent such illnesses through vaccination. Influenza vaccination itself works by producing antibodies against the flu virus shortly after the injection which can cause fever in some cases. Thus, many individuals with MS and many physicians have been wary of using influenza vaccine for fear that it, or a resultant fever, would itself precipitate an MS attack.
Previous studies of flu vaccine in MS have suggested that it is safe for people with MS. However, in prior studies patients have not been followed through an entire flu season, and thus the longer-term consequences of the vaccine were unknown. Moreover, investigators were not blinded -- they knew which patients got vaccine and which ones did not. This could have introduced some bias into their conclusions.
Under the leadership of Aaron Miller, MD, investigators from Maimonides Medical Center in Brooklyn, New York and four other MS centers in northeastern U.S. administered either influenza vaccine or an identical-appearing placebo to 104 persons with relapsing-remitting MS. The study was blinded -- neither the examining physicians nor the patients knew who had received vaccine or placebo.
Relapsing-remitting MS was chosen for study because persons with that form of the disease are the most likely to experience clearly defined and recordable MS attacks. Patients were vaccinated in early autumn, and were followed for six months -- virtually the entire flu season -- to determine whether they experienced any bouts of the flu or attacks of MS.
During the four weeks following vaccination (when vaccine-related MS attacks might be most likely to occur), three vaccine patients and two placebo patients experienced attacks, a difference that was not statistically significant (or greater than would have been expected by chance). Over the course of the six-month follow-up, the vaccine patients experienced 11 MS attacks (annual rate of 0.45) vs. six attacks for placebo patients (annual rate of 0.22). While there was a difference in rates, this difference was not statistically significant. Attack rates for vaccine-treated patients were lower than in other groups of MS patients that have been studied in the past. Also during the six-month follow-up period, there was evidence of MS progression in eight vaccine patients and 10 placebo patients -- again, a difference that was not statistically significant.
This was the largest prospective study to date on the effects of influenza vaccination on relapsing-remitting MS, and the only one to follow patients through an entire flu season. The results indicate that influenza vaccination is not associated with a subsequent, statistically significant increase in the rate of MS attacks or with greater progression of the disease over six months following vaccination. Based on these and previous findings with rather small populations, it is the view of the National Multiple Sclerosis Society's Medical Advisory Board that influenza vaccination may be considered for use in the MS population.
© 1997 The National Multiple Sclerosis Society
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