The article presents an overview of modern approaches to vaccine prevention in multiple sclerosis (MS). Compared with the general population, patients with MS have been shown to have an increased risk of morbidity, a tendency to have a more severe course, and a greater mortality from vaccine-preventable infections. At the same time, in Russia, until recently, traditionally adhered to a conservative tactic of limiting vaccination in patients with autoimmune diseases, including MS. The use of various disease-modifying therapies (DMT) may also affect the susceptibility to infections and the severity of their course. Screening for latent infections, determination of immune status, collection of history of past infections and development of a vaccination plan based on these data are an important part of the preparation before the appointment of DMT to control the occurrence or reactivation of infections. The use of inactivated, subunit, conjugate, and toxoid-based vaccines are preferable for MS patients. When developing a vaccination plan, avoid live-attenuated vaccines whenever possible. There are no restrictions on vaccination during first line DMT intake. In case of vaccination in MS patients while using immunosuppressants, including drugs for immune reconstitution therapy, an individual risk assessment and timing are required. The available data on the awareness of patients about vaccine prophylaxis are significantly limited and require mass information events.