{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:16:15Z","timestamp":1793776575138,"version":"4.6.1"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","award":["Investigator initiated trial \/ partly financed"],"award-info":[{"award-number":["Investigator initiated trial \/ partly financed"]}],"id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Complete vaccination coverage is recommended by multiple sclerosis (MS) societies for patients with multiple sclerosis (pwMS) to mitigate infection risks associated with disease-modifying therapies (DMTs). <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives:<\/jats:title><jats:p> To analyze vaccination coverage and its determinants in pwMS compared to healthy controls, considering vaccination hesitancy, MS-specific vaccination beliefs, trust in information sources, and the role of general practitioners (GPs). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> This cross-sectional multicenter observational study was conducted in six German MS centers. The primary endpoint was a vaccination index (VI) comprising eight standard vaccinations (range 0\u20131, with higher VI indicating better vaccination coverage). Secondary endpoints included validated measures of general vaccination hesitancy, MS-specific vaccination beliefs, and trust in information sources. Data were collected through questionnaires, vaccination card analysis, and a survey of GPs who vaccinate pwMS. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> VI tended to be lower in pwMS ( n\u2009=\u2009397) compared to healthy controls ( n\u2009=\u2009300; 0.58\u2009\u00b1\u20090.30 vs 0.62\u2009\u00b1\u20090.31, p\u2009=\u20090.057). In pwMS receiving highly effective DMTs, VI did not differ significantly from those on no\/platform DMTs. Vaccination hesitancy was comparably low, with no differences between pwMS and controls. Vaccination hesitancy, beliefs, and trust in information sources explained only 10%\u201316% of the variance in VI. Among 109 GPs, 82% cited reluctance to vaccinate pwMS due to concerns about MS-related side effects or interactions with DMTs. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Despite clear recommendations from MS societies for full vaccination of all pwMS, vaccination coverage remains worryingly low. Approximately half of the patients lack standard vaccination coverage, even those on highly effective DMTs. In fact, vaccination coverage in pwMS tended to be even lower than in healthy controls. Vaccination hesitancy and other intrinsic factors do not sufficiently explain the low vaccination rates. Inconsistent vaccination recommendations from GPs due to uncertainties about vaccine safety and DMT interactions likely contribute. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562864241309806","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T17:05:40Z","timestamp":1738170340000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Vaccination coverage and its determinants in patients with multiple sclerosis\u2014a multicenter cross-sectional study"],"prefix":"10.1177","volume":"18","author":[{"given":"Paula","family":"Schade","sequence":"first","affiliation":[{"name":"Department of Neurology, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Anh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Steinle","sequence":"additional","affiliation":[{"name":"Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor","family":"Pelea","sequence":"additional","affiliation":[{"name":"Department of Neurology, Central Hospital Suhl, Suhl, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Franken","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birte","family":"Elias-Hamp","sequence":"additional","affiliation":[{"name":"Neurological Private Practice, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit","family":"Becker","sequence":"additional","affiliation":[{"name":"Neurological Private Practice, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Merkelbach","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heinrich-Braun Hospital, Zwickau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Richter","sequence":"additional","affiliation":[{"name":"Neurological Private Practice, Mind MVZ, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Wagner","sequence":"additional","affiliation":[{"name":"Neurological Private Practice, Mind MVZ, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Geis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-9711","authenticated-orcid":false,"given":"Florian","family":"Rakers","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jena University Hospital, Am Klinikum 1, Jena 07747, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"bibr1-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000768"},{"key":"bibr2-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-017-0562-0"},{"key":"bibr3-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.04.004"},{"key":"bibr4-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrleng.2020.02.010"},{"key":"bibr5-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008157"},{"key":"bibr6-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520952310"},{"key":"bibr7-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231168043"},{"key":"bibr8-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-019-02905-1"},{"key":"bibr9-17562864241309806","doi-asserted-by":"publisher","DOI":"10.4161\/hv.24657"},{"key":"bibr10-17562864241309806","volume-title":"Thirteenth general programme of work, 2019\u20132023: promote health, keep the world safe, serve the vulnerable","author":"World Health Organization","year":"2019"},{"key":"bibr11-17562864241309806","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01883"},{"key":"bibr12-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.2968"},{"key":"bibr13-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2015.06.018"},{"key":"bibr14-17562864241309806","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"bibr15-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1027\/1015-5759\/a000663"},{"key":"bibr16-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"bibr17-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-018-0036-9"},{"key":"bibr18-17562864241309806","first-page":"3","volume":"2023","author":"Impfkommission S.","journal-title":"Epidemiol Bull"},{"key":"bibr19-17562864241309806","volume":"56","author":"Gasparini R","year":"2015","journal-title":"J Prev Med Hyg"},{"key":"bibr20-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1007\/s10459-010-9222-y"},{"key":"bibr21-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199001000-00010"},{"key":"bibr22-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.12.081"},{"key":"bibr23-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.10.013"},{"key":"bibr24-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1159\/000519582"},{"key":"bibr25-17562864241309806","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10071154"},{"key":"bibr26-17562864241309806","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20200105"},{"key":"bibr27-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-021-01011-w"},{"key":"bibr28-17562864241309806","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11070890"},{"key":"bibr29-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15748"},{"key":"bibr30-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000001099"},{"key":"bibr31-17562864241309806","first-page":"164","volume":"38","author":"Bizjak M","year":"2020","journal-title":"Clin Exp Rheumatol"},{"key":"bibr32-17562864241309806","doi-asserted-by":"crossref","DOI":"10.1007\/s00393-007-0150-z","volume":"66","author":"Minden K","year":"2007","journal-title":"Z Rheumatol"},{"key":"bibr33-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2024.05.049"},{"key":"bibr34-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2023.122852"},{"key":"bibr35-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221150881"},{"key":"bibr36-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvacx.2023.100394"},{"key":"bibr37-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103236"},{"key":"bibr38-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2018.1459252"},{"key":"bibr39-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.06.065"},{"key":"bibr40-17562864241309806","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines8030480"},{"key":"bibr41-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.08.081"},{"key":"bibr42-17562864241309806","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.10.089"}],"container-title":["Therapeutic Advances in Neurological Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864241309806","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562864241309806","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864241309806","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T02:53:59Z","timestamp":1740884039000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562864241309806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":42,"alternative-id":["10.1177\/17562864241309806"],"URL":"https:\/\/doi.org\/10.1177\/17562864241309806","relation":{},"ISSN":["1756-2864","1756-2864"],"issn-type":[{"value":"1756-2864","type":"print"},{"value":"1756-2864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"article-number":"17562864241309806"}}