Is intimacy okay for a patient with Multiple Sclerosis (MS) if their partner has received a typhoid vaccine?

Intimacy is Safe for MS Patients Whose Partners Received Typhoid Vaccine

Intimacy is completely safe for patients with Multiple Sclerosis (MS) when their partner has received a typhoid vaccine, as secondary transmission of vaccine organisms does not occur with typhoid vaccines.

Typhoid Vaccine Types and Transmission Risk

There are two main types of typhoid vaccines available:

1. Parenteral inactivated typhoid vaccine

   • Heat-phenol-inactivated vaccine administered subcutaneously
   • Efficacy ranges from 51%-76% 1
   • Contains no live organisms, so no risk of transmission

2. Oral live-attenuated Ty21a vaccine

   • Efficacy approximately 67% 1
   • Despite being a live-attenuated vaccine, secondary transmission does not occur because:
     • "Secondary transmission of vaccine organisms does not occur because viable organisms are not shed in the stool of vaccinees" 1

Safety for MS Patients and Their Partners

Research specifically examining MS patients and vaccinations supports the safety of intimacy:

• No correlation has been found between typhoid fever vaccination and risk of MS 2
• Systematic review and meta-analysis showed typhoid fever vaccination has no significant impact on MS risk (OR 1.05,95% CI 0.72-1.53) 3

Considerations for MS Patients

While the partner's typhoid vaccination poses no risk to the MS patient during intimacy, it's worth noting:

• Live-attenuated vaccines (like the oral typhoid vaccine) are generally contraindicated for MS patients themselves if they are on immunosuppressive therapies 4
• This contraindication applies to the MS patient receiving the vaccine, not to intimate contact with someone who has received it

Potential Concerns and Clarifications

Some might worry about transmission of vaccine strains during intimate contact, but:

• The inactivated parenteral vaccine contains no live organisms
• The live-attenuated oral vaccine does not result in shedding of viable organisms 1
• The typhoid vaccine is indicated for "travelers to areas where a recognized risk of exposure to S. typhi exists" and "persons with intimate exposure to a documented typhoid carrier" 1, but this refers to carriers of wild-type infection, not vaccine recipients

Conclusion

Intimate contact between an MS patient and a partner who has received a typhoid vaccine poses no risk to the MS patient. The vaccine strain is not transmitted through intimate contact, as confirmed by ACIP guidelines stating that "secondary transmission of vaccine organisms does not occur" 1.