Background: As therapy for MS has expanded to include multiple immunomodulatory and immunosuppressive therapies, the need to consider patient vaccination status has emerged as a salient issue in the treatment of MS. Unfortunately, there is little research or consensus about how vaccination in these patients should be addressed. Methods: A search of primary literature on the topic of potential pathogens and available vaccinations in immunosuppressed patients was performed. We reviewed the limited available information in the MS, gastroenterology, and rheumatology literature. As well, the current Canadian immunization guide was referred to along with expert opinion from public health nurses and infectious disease specialists. Results: There is currently little consensus about vaccination protocols for patients initiating immunosuppressive therapy. We integrated information from all of our sources to create a preliminary protocol for the vaccination of MS patients prior to initiation of immunosuppressive therapy. Conclusions: More work needs to be done to create standardized vaccination protocols for MS patients who will be undergoing immunosuppressive therapy. We have created a preliminary protocol in conjunction with public health to standardize the vaccinations that MS patients receive. We hope that this will streamline immunization of patients immediately after diagnosis of MS so that initiation of immunosuppressive therapy will not be delayed in the future.