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Vaccines and Myasthenia Gravis

Reviewed by: HU Medical Review Board | Last reviewed: May 2021

Vaccines (also called immunizations) expose the immune system to a potential future threat to “train” it to respond strongly later on. By training the immune system this way, getting many illnesses can be avoided completely. If a person does get sick later, vaccines allow the person to have much milder form of the illness.

How do they work?

When a person gets a vaccine, their body mounts an immune response and starts creating antibodies and immune cells. These antibodies and immune cells target a particular illness the vaccine is designed to fight. Later, if the person comes in contact with that same illness, their body is prepared to fight the infection.

Vaccines need an active, healthy immune system to train. This is why people with a weakened immune system have to be careful about which vaccines they get and when. People with severe myasthenia gravis (MG) and people taking large doses of immunosuppressive drugs have weakened immune systems. However, most people living with MG can get all the routine vaccinations other people get.1

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Preventing infections

Getting vaccinated is an important part of MG care. With a weakened immune system, illnesses that other people can fight, like the flu, shingles, or pneumonia, may become life-threatening. Preventing sickness from happening in the first place through vaccination helps keep people with MG healthier overall.1

It is especially important to prevent respiratory infections in people with generalized MG because these infections can trigger flares or a myasthenic crisis.1

Which ones should I get?

Most vaccines are safe for people with myasthenia gravis. Vaccines come in several forms that may be injected by shot, given by mouth, or sprayed into the nose. The vaccines people with MG usually need are:1,2

  • Influenza (flu)
  • TdaP (tetanus, diphtheria, and pertussis)
  • HPV (human papillomavirus)
  • Hepatitis B
  • Meningococcal (meningitis)
  • Pneumonia
  • Measles, mumps, rubella (MMR)
  • Varicella (chickenpox and shingles)

The only exceptions are that people taking strong immunosuppressants should not be given live vaccines. This includes:1,2

  • Nasal flu spray
  • 1 type of shingles vaccine
  • Yellow fever vaccine
  • Measles, mumps, rubella (MMR)

Non-live versions of the flu shot and shingles vaccine are safe and recommended for people with MG. The yellow fever vaccine is only needed if you travel to countries where yellow fever is a problem. The MMR vaccine should be avoided in people on strong immunosuppressive drugs. However, most people have probably already gotten their MMR vaccine as children.3

Some people believe that the flu vaccine may cause flares or flu in people with MG. However, multiple studies have found the flu vaccine safe in people with mild to moderate MG. People with severe myasthenia gravis often have more complicated health issues that must be managed carefully. Still, vaccines may be safe for them too.3,4

Is there a vaccine for MG?

At this time, there is not a vaccine that prevents MG. However, scientists around the world are trying to develop one for MG and other autoimmune diseases. There are also several new treatments being studied. However, these experiments are what is called basic research. “Basic” means the science is done in labs and is years away from being ready to test on humans.5,6