MS patients show ‘vaccine fatigue’ after pandemic, German study finds
Many believed their shots were up to date despite missing doses
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A study from Germany finds willingness to get routine vaccines has dropped among people with MS since the COVID-19 pandemic, revealing growing "vaccine fatigue" and gaps in medical records. (Photo from iStock)
- Patients with MS show post-pandemic vaccine fatigue, with willingness to receive routine immunizations dropping significantly from 81.1% to 66.3%.
- Key concerns include fears that vaccinations will worsen MS symptoms or cause side effects, alongside discrepancies between perceived and documented vaccination status.
- Strengthening communication between neurologists and family doctors is critical to address patient concerns and improve vaccination confidence and coverage.
Fewer people with multiple sclerosis (MS) are willing to receive recommended routine vaccines today than before the COVID-19 pandemic, even as neurologists and family doctors talk with them more frequently about immunization, a new study in Germany has found.
While vaccination records showed improved coverage for several vaccines, researchers discovered a sharp drop in overall willingness to get vaccinated. At the same time, many patients who assumed their shots were fully up to date actually had missing doses or boosters in their medical charts. Vaccine-related concerns were also associated with lower vaccination coverage and uptake.
The findings point to possible “post-pandemic vaccination fatigue in patients with MS,” a group for whom preventable infections carry serious health risks, according to researchers.
“Persistent discrepancies between perceived and documented vaccination status and the impact of vaccine-related concerns highlight the need for more targeted strategies to strengthen vaccination confidence and improve immunization coverage,” they wrote.
The study, “Changes in vaccination status, willingness and knowledge in patients with multiple sclerosis: Results from a five-year longitudinal study,” was published in Sage Journals.
Vaccine attitudes and care in MS
Vaccination is an important part of MS care because people with the condition face a higher risk of infections. In addition, several common MS treatments, known as disease-modifying therapies, work by modulating the immune system. Because these medications can blunt the body’s ability to mount a strong immune response to a vaccine, doctors strongly recommend getting fully vaccinated before starting them.
To track how vaccination attitudes and actual immunization rates shifted over time, researchers followed 175 adults with MS receiving care at the Ecumenical Hainich Hospital in Mühlhausen, Germany. Participants were first assessed in 2019-2020, most before the COVID-19 pandemic, and again in 2024-2025.
At the first assessment, participants had a mean age of 45.8 years, and 70.3% were women. They answered questions about vaccination, and the researchers reviewed vaccination records and other available medical documents to assess coverage across 26 vaccines.
Vaccinations were considered complete when primary doses and appropriate boosters were documented within the recommended intervals.
Over about five years, willingness to receive all officially recommended vaccines fell significantly from 81.1% to 66.3%. Yet, at the last assessment, more participants reported getting vaccination advice in the past year from their doctors — 70.8% versus 34.3% in 2019-2020. Regular vaccination checks by neurologists also rose, from 5.7% to 47.7%.
Coverage gains alongside growing doubts
Among participants who expressed reluctance to get vaccinated, safety was a common concern. At follow-up, 41.4% feared vaccination could worsen their MS, and 37.9% worried about side effects, rates largely unchanged from five years earlier. Five participants (8.6%) said their general practitioner had advised against vaccination, something no patient had reported initially.
Despite growing hesitation, actual coverage improved noticeably for several key diseases. Rates rose for tetanus (from 72.4% to 87.9%) and diphtheria (from 71.8% to 84.7%). Pneumococcal vaccination, which protects against bacteria that can cause pneumonia and other serious infections, also increased significantly (from 20.7% to 34.5%). The largest rate increase was for shingles (herpes zoster), from 0.9% to 28.9%.
What people thought about vaccines at the start of the study was also linked to their later vaccination status. Those with early doubts were significantly less likely to stay up to date on their shots. Conversely, patients who had already received flu vaccines annually or every few years were more likely to accept other recommended immunizations.
However, participants’ perceptions of their vaccination status did not always match their records. For several vaccines, fewer than half of participants who believed they were fully vaccinated had records confirming all recommended doses and boosters.
COVID-19 responses offered further clues about changing attitudes. Although 90.1% reported receiving at least one dose of a COVID-19 vaccine, 58.1% were unwilling to receive another dose, and 23.8% said the pandemic had made them more hesitant about standard vaccinations. Reasons for declining another dose included concerns about side effects, possible infection despite vaccination, and doubts about how well the vaccines work.
“Our findings suggest the emergence of post-pandemic vaccination fatigue and point to potentially inconsistent vaccination advice from different healthcare providers,” the researchers wrote, stressing that stronger communication between family doctors and neurologists is essential to rebuild patient confidence in vaccines.
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