Major advancements in the management of multiple sclerosis and related disorders with immunotherapies have also increased the risk for infections and raised questions about the need for and efficacy of vaccinations. Several types of infections can occur in individuals on immunotherapies; however, the vulnerability to infections depends on the specific class of treatment. Careful monitoring for infections and prompt investigations are necessary because atypical presentations and rapid progression may occur. Patient education is also key to early recognition of these infections. Immunotherapies can compromise the protective immune responses to vaccines; hence, timing the vaccines by giving them before starting or dosing of immunotherapies is important.
Nath et al. (2026) studied this question.