Vaccinations and MS are an important topic, especially for people receiving immune-modifying or immunosuppressive therapies. In this interview, I talk with Dr. Thomas Grüter about why vaccinations can help protect people with multiple sclerosis from infections, how MS therapies may influence vaccine response, and why good timing matters.
This interview was originally published in German in December 2024. For this English version, I have adapted some parts to make them easier to understand for an international audience. Some examples in the original conversation refer to the German healthcare system, German vaccination recommendations, or the German VAC-MAC project. Where relevant, I have added context so that listeners outside Germany can better apply the information to their own situation.
Please note that vaccination schedules, reimbursement, approval status, and medical recommendations can differ from country to country. This episode is for information and encouragement only and does not replace medical advice. Please discuss your personal vaccination plan with your neurologist or healthcare provider.
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More InformationTable of Contents
Introduction – Who is Dr. Thomas Grüter?
Nele von Horsten:
Hello Dr. Grüter, I am very happy to have you as my guest today. Could you please introduce yourself to our listeners?
Dr. Thomas Grüter:
My name is Dr. Thomas Grüter. I am a neurologist and work at St. Josef Hospital in Bochum, Germany. Alongside my clinical work, I am involved in research and patient education, especially in areas such as multiple sclerosis, also known as MS, and other autoimmune diseases.
Personal motivation for becoming a neurologist
Nele von Horsten:
Why did you choose neurology?
Dr. Thomas Grüter:
I became interested in the nervous system early on, especially because of its complexity and the many challenges connected with neurological diseases.
For me, it is important not only to support patients clinically, but also to provide clear and evidence-based information. Good education helps people make informed decisions about their health.
The VAC-MAC project: vaccination education for MS, arthritis, and colitis
How did the idea for VAC-MAC come about, and what connects MS, arthritis, and colitis?
Dr. Thomas Grüter:
The idea came from the need to provide better information about the benefits of vaccinations for people with autoimmune or immune-mediated diseases.
MS, arthritis, and colitis have one important thing in common: the immune system is misdirected and contributes to inflammation in the body. At the same time, people with these conditions may be more vulnerable to infections, especially when they receive therapies that suppress or modify the immune system.
International context:
VAC-MAC is a German project focused on vaccination education for people with multiple sclerosis, arthritis, and colitis. If you live outside Germany, similar information may be available through your national MS society, neurological association, rheumatology or gastroenterology organization, public health authority, or local patient advocacy group.
Myths about vaccinations and autoimmune diseases
What rumors or myths exist about vaccinations and autoimmune diseases? Is there scientific evidence for them?
Dr. Thomas Grüter:
One common claim is that vaccinations can trigger autoimmune diseases. From a scientific point of view, this claim is not supported.
Studies do not show a causal relationship between vaccinations and the development of autoimmune diseases such as MS. What sometimes happens is a coincidence in timing. For example, a person may be diagnosed with MS shortly after receiving a vaccine. This can easily create the impression that the vaccine caused the disease, even when there is no causal connection.
This is one reason why clear education is so important. People need reliable information, not fear-based assumptions.
Why are vaccinations particularly important for people with autoimmune diseases such as MS?
Dr. Thomas Grüter:
Autoimmune diseases such as MS, and some of the therapies used to treat them, can affect the immune system.
Infections such as influenza, pneumonia, or shingles may have a more severe course in some people with MS. Infections can also put stress on the body and may contribute to relapses or worsening of symptoms.
Vaccinations can help reduce these risks. They are a preventive measure, meaning they help protect people before an infection occurs.
How infections without vaccine protection can affect MS
What impact can an infection have on MS if a person is not protected by vaccination?
Dr. Thomas Grüter:
Infections without vaccine protection can sometimes be more severe. They may lead to hospital stays, prolonged recovery, and, in some cases, MS relapses.
A relapse is a new or worsening neurological symptom caused by inflammatory activity in the central nervous system. Relapses can sometimes leave lasting damage. That is why prevention is so important.
Vaccinations are not the only form of protection, but they are one of the most effective tools we have to reduce the risk of certain serious infections.
What is the difference between inactivated vaccines and live vaccines, and when can live vaccines make sense?
Dr. Thomas Grüter:
Inactivated vaccines contain either killed pathogens or parts of a pathogen. They cannot cause the infection they are designed to protect against.
Live vaccines contain weakened but still living pathogens. They can create a strong immune response, but they are used more carefully, especially in people whose immune system is suppressed.
For people receiving immunosuppressive MS therapies, live vaccines are usually not recommended because even a weakened pathogen may pose a risk. This is why vaccination planning should ideally happen before starting certain MS therapies.
International context:
The exact rules may depend on the specific vaccine, the MS therapy, national guidelines, and the person’s individual immune status. Please ask your neurologist or healthcare provider which vaccines are suitable for you.
How do MS therapies influence vaccine protection?
Dr. Thomas Grüter:
Some MS therapies can reduce the immune response to vaccines.
For example, therapies that target B cells, such as ocrelizumab, known as Ocrevus, or ofatumumab, known as Kesimpta, may reduce the antibody response after vaccination. Antibodies are proteins produced by the immune system that help recognize and fight infections.
However, this does not mean that vaccination is useless. Vaccines can also activate other parts of the immune system, including cellular immune responses. Even if the response is weaker, vaccination may still provide meaningful protection.
This is why timing matters. The goal is to vaccinate when the immune system is most likely to respond well.
When is the right time for vaccinations?
Dr. Thomas Grüter:
Ideally, vaccinations should be reviewed and updated before starting a new MS therapy, especially before therapies that strongly affect the immune system.
If this is not possible, vaccinations can often still be given during stable phases of treatment or at suitable points between treatment cycles.
For example, after infusion therapies that affect B cells, doctors may recommend waiting several months before giving certain vaccines, depending on the treatment schedule and the individual situation.
The key message is: do not leave vaccination planning to chance. Bring it up with your neurologist early, especially if you are about to start or switch MS therapy.
International context:
The timing of vaccination can depend on the medication used, the dosing schedule, blood test results, and national medical guidance. Please do not stop, delay, or change your MS therapy without medical advice.
Specific vaccination recommendations for people with MS
Which vaccinations should people with MS consider, and how often do they need boosters?
Dr. Thomas Grüter:
People with MS should generally receive the standard vaccinations recommended for adults in their country.
These often include protection against tetanus, diphtheria, pertussis, also known as whooping cough, and seasonal influenza. Depending on age, risk factors, medication, and national recommendations, vaccines against pneumococcal disease and shingles may also be important.
In Germany, for example, pneumococcal and herpes zoster vaccinations may be recommended earlier for people with certain chronic conditions or immunosuppressive therapies than for the general population.
International context:
Please check the vaccination recommendations in your own country. They may differ from German recommendations in terms of age, risk groups, booster intervals, vaccine availability, and reimbursement.
What are the vaccination recommendations for women who are planning a pregnancy, are pregnant, or are breastfeeding?
Dr. Thomas Grüter:
For women who are planning a pregnancy, it is best to review vaccination status before becoming pregnant. This allows enough time to update missing vaccines, including vaccines that should not be given during pregnancy.
During pregnancy, vaccinations against influenza and whooping cough are often recommended in many countries because they can help protect both the mother and the baby.
During breastfeeding, many vaccinations are possible, but the details depend on the vaccine, the mother’s MS therapy, and local guidelines.
The most important advice is to plan early. Women with MS should discuss vaccination, pregnancy planning, and MS therapy together with their neurologist and gynecologist or obstetrician.
Further information about VAC-MAC
Where can people find more information about the VAC-MAC project?
Dr. Thomas Grüter:
The website www.vac-mac.de provides compact information and practical materials in German. One example is a vaccination letter that can serve as guidance for patients and physicians.
International context:
If you do not live in Germany, you can use VAC-MAC as a starting point, but please also check information from your national MS society, local healthcare authority, or neurological association.
Final message
Is there anything else you would like to share with our listeners?
Dr. Thomas Grüter:
Do not let myths discourage you.
Vaccinations are one of the great achievements of modern medicine. They can provide effective protection against serious diseases. For people with MS, this protection can be especially important.
Talk to your healthcare team, ask questions, and make informed decisions based on evidence rather than fear.
Nele von Horsten:
Thank you very much, Dr. Grüter, for your time and for sharing this important information.
Dr. Thomas Grüter:
Thank you very much for the invitation.
See you soon and try to make the best out of your life,
Nele
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