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Der Nervenarzt

, Volume 81, Issue 2, pp 181–193 | Cite as

Impfen und Multiple Sklerose

  • M. LöbermannEmail author
  • A. Winkelmann
  • E.C. Reisinger
  • U.K. Zettl
Übersichten

Zusammenfassung

Wie bei anderen chronisch-entzündlichen Erkrankungen sind Impfungen zum Schutz vor Infektionskrankheiten auch bei Patienten mit Multipler Sklerose (MS) von großer Bedeutung, denn bakterielle und virale Infekte können MS-Schübe auslösen. Berichte über eine mögliche Progression der Erkrankung durch einzelne Impfungen haben zu einer generellen Zurückhaltung vor Schutzimpfungen auf Seiten der betroffenen Patienten und der behandelnden Ärzte geführt. Für die meisten Impfstoffe sind Studien bekannt, die das Risiko bei Patienten mit MS untersucht haben. Einige Impfungen, wie die Gelbfieberimpfung, können bei MS nicht empfohlen werden. Tetanus- oder Hepatitis-B-Impfungen dagegen stellen nach aktuellem Kenntnisstand keinen Risikofaktor für die Entstehung oder Progression einer MS dar. Vor und während einer immunmodulierenden Therapie bei MS-Patienten sollte auf einen ausreichenden Schutz vor impfpräventablen Erkrankungen geachtet werden.

Der vorliegende Beitrag fokussiert einerseits auf die Indikationen und möglichen spezifischen Nebenwirkungen von Impfungen bei MS-Patienten und andererseits auf Probleme, die unter einer immunmodulatorischen Therapie beachtet werden müssen.

Schlüsselwörter

Multiple Sklerose Krankheitsprogression Impfungen Impfstoff Nebenwirkungen 

Vaccination and multiple sclerosis

Summary

Vaccinations to prevent communicable diseases are, like in other chronic diseases, of special importance in patients with multiple sclerosis (MS). Various bacterial and viral infections have been shown to induce relapses of MS. Reports of possible adverse effects of vaccinations on the course of multiple sclerosis have led patients and treating physicians to exercise caution in the use of vaccines. A number of vaccines have been studied with respect to the risk in MS patients. Some vaccines, for example against yellow fever, are not indicated in MS due to the risk of MS exacerbation. In contrast, tetanus or hepatitis B vaccines do not represent a risk for manifestation or disease progression of MS. Before and during immunomodulatory therapy of MS special attention should be given to adequate protection against vaccine preventable diseases.

This paper reviews the indications and specific side effects of vaccinations in MS patients. Additionally, issues of vaccination under immunomodulatory therapy of MS are discussed.

Keywords

Multiple sclerosis Disease progression Vaccine Vaccination Side effects 

Notes

Interessenkonflikt

Der korrespondierende Autor weißt auf folgende Beziehungen hin:

Prof. Dr. U.K. Zettl ist als Referent für die Firma Bayer Health Care, Biogen Idec, Merck Serono und Aventis/Teva tätig.

Prof. Dr. E. C. Reisinger erhielt Vortragshonorare und Reisekostenzuschüsse von Sanofi Pasteur MSD, GlaxoSmithKline, Novartis Behring, Roche Pharma, und Bayer.

Dr. A. Winkelmann erhielt Vortragshonorare und Reisekostenzuschüsse folgender Firmen: Schering, Bayer Health Care, Octapharma AG und Merck Serono.

Dr. M. Löbermann erhielt Vortragshonorare und Reisekostenzuschüsse folgender Firmen: Sanofi Pasteur MSD, GlaxoSmithKline, Novartis Behring und Roche Pharma.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  • M. Löbermann
    • 1
    Email author
  • A. Winkelmann
    • 2
  • E.C. Reisinger
    • 1
  • U.K. Zettl
    • 2
  1. 1.Zentrum für Innere Medizin, Klinik und Poliklinik für Innere Medizin II, Abteilung für Tropenmedizin, Infektionskrankheiten und NephrologieUniversität RostockRostockDeutschland
  2. 2.Klinik und Poliklinik für NeurologieUniversität RostockRostockDeutschland

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