Traveller's vaccines when you have MS

[malaholic]

I have seen some older threads talking about the safety of 'common' shots like the flu vaccine. I am wondering if anyone on the board has experience with other vaccines, specifically:

• Typhoid
• Hepatitis A
• Japanese Encephalitis

I will be traveling to a somewhat remote-wish region in China later this spring, and the above are the vaccines recommended for US citizens traveling there. I can't seem to find much data regarding their safety for an MS patient taking Copaxone, so I thought I'd ask here to see if anyone had any anecdotal experience to share, either that you noticed issues or flares after one of these vaccines, or that you didn't.

My MS neuro's reply to this question was: "Copaxone is probably the best medication to be on if you need vaccinations. We generally advise avoiding live viruses in vaccinations. We don't provide much advice other than that, since you need to be comfortable with either risk of infection while abroad vs risk of exacerbation, which is probably fairly low."

On the NMSS website, it states “Other immunizations, such as those for pneumonia, meningitis, typhoid, polio, hepatitis A, and pertussis, do not have published studies addressing their safety in MS.”. NMSS doesn't mention the Japanese Encephalitis vaccine at all.

Anyone have any experience with any of these? Advice?

[Nabbosa]

My vaccination experience

I had almost every shot there is before going on interferon, and never had any trouble. That said, I'd not yet been diagnosed, and even now my MS is extremely mild.

I'm personally pretty fearless about the vaccines. I'd take precautions with the live vaccines - my neuro and I talked about taking an interferon break when it's time for the big one of those I need.

That said, I'll tell you that typhoid has always wiped me out. I first had it before I had MS (for sure), and I got a mild fever that afternoon. Everything was fine later. Now, I tend to get a little bit of an uncomfortable stomach - nothing horrible, but I prefer to go with soothing foods for dinner that night, be prepared with an analgesic in case I have a slightly raised temperature, and watch a movie. Oh - and double-check with your provider before going in for the typhoid because there are two versions - one is live, one is attenuated. The attenuated is a shot, if I remember correctly, whereas the live is oral. Just make sure they have the one you are comfortable taking.

Hepatitis just made my arm tender for a day or two.

I've never had the Japanese encephalitis - I work on the other side of the world (East/Central Africa).

Here is my own personal opinion on the issue, too: my first MS exacerbation was likely triggered by influenza. The shots haven't bothered me - nor have any of the others I've gotten while on interferons (pneumococcal, for example). I know how horribly my body would react to getting one of the 104-degree-fever kinds of diseases for which there is a vaccination, so I find the risk is worth it for me. YMMV - as I wrote, my MS is mercifully mild (and I'm thankful for that every single day).

Keep in mind that the Hep A will also protect you at home should you get contaminated food somewhere. It's not as common in the U.S. and Canada as it is overseas, but it does happen from time to time.

Hope you have a great time on your trip!

[malaholic]

Hi Nabbosa, thank you for sharing your experiences with the typhoid/hepA shots! I'm glad to hear that your MS is and has been mild, and I hope that continues to be the case for you.

I think the reaction you describe to the typhoid shot is probably fairly common - I remember my boss felt similarly after having a typhoid shot prior to a trip to India. But it sounds as though for you it did not cause noticeable exacerbation of MS-related symptoms and that's good to hear.

My neuro in a subsequent reply suggested that I consult with a "travel medicine" doctor (which I hadn't known was a thing, but then I'd not had a reason to know this until now) to learn more about the vaccine options. So I think that will be my next move. In the meantime if anyone else has any experience to share I'd love to hear it; and I will of course post back to this thread to share my decisions and experience with the vaccines if I do have them, in case anyone else later searches on a similar topic.

[Nabbosa]

adding a little more

Malaholic -

One more quick note: be sure that anything a travel doctor says, you let them know you already spoke to your neuro. MS sometimes freaks out doctors who don't deal with it often. If you get a wacky reaction from the travel doctor, know that it is likely their own idiosyncrasy, not a general ban on MS patients traveling.