The medication that you may be prescribed to manage your condition means that if you are having any routine vaccinations or planning to travel and require vaccinations for this you need to be aware of if they may impact you negatively. Live vaccines are  NOT safe if you are on drugs that suppress your immune system.

Vaccinations 

The following routine vaccinations are offered to all young adults and are safe to be given whatever medications you are taking: 

• HPV vaccine - this protects against cervical cancer and you are offered this when you are 12/13 years old. There are two injections six months apart.
• 3 in 1 teenage booster - this is a single injection offered when you are 14 years old that protects against diptheria, tetanus and polio.
• MenACCWY vaccine - this is offered when you are 14 years old and is a single injection that protects against meningitis A, C, W and Y.
• Flu vaccine INJECTION only - this protects against flu and is recommended for patients on drugs that suppress their immune system. The nasal spray vaccine is not safe as it is a live vaccine.
• Pneumonia vaccine - this protects against pneumonia. If you are on medications that suppress your immune system we recommend that you have this vaccine. We might suggest that you have this repeated when you have transferred to adult services depending on the drugs you are taking.
• Covid vaccine - it is extremely important for you to have the Covid vaccine when offered. If you receive a medication called rituximab or take >20mg of prednisolone, it would be best to speak to your rheumatology team about the timing of the vaccine.

The following medications are ones that we use that may suppress your immune system. Click on them to find out more:

• Abatacept (Orencia)
• Adalimumab (Humira)
• Azathioprine
• Certolizumab pegol (Cimzia)
• Cyclophosphamide
• Etanercept (Enbrel or Benepali)
• Golimumab (Simponi)
• Infliximab (Remicade or Inflectra)
• Leflunomide
• Mercaptopurine
• Methotrexate
• Mycophenolate mofetil  (Cellcept)
• Prednisolone (steroid tablets)
• Rituximab (Mabthera or Truxima) - Flu and pneumonia vaccines need to be given at specific times before or after rituximab so check with your Rheumatology nurse before having any vaccines if you are on this drug. Also, if you need a tetanus booster vaccine (because you have a dirty cut/wound) you may need an immunoglobulin injection rather than just the booster  so please contact your Rheumatology team.
• Tocilizumab (Ro-actemra)

Drugs that are used that do not suppress your immune system:

• Hydroxychloroquine
• Sulfasalazine
• Gold Injections
• Anti-inflammatory medications e.g. ibuprofen, naproxen

Travel 

If you are planning on going travelling and think you may need vaccinations you can find out more information on the websites NHS Fit for Travel and Travel Health Pro. You can also talk to the nurse at your GP surgery or travel clinic about what vaccinations may be needed. 

Once you know which vaccinations are required - you need to check if any of them are live vaccines. Live means they contain a weakened small amount of the actual disease you are being protected against. Most immune systems use this to create their own antibodies to protect against the disease. However, if you are on drugs that suppress your immune system you will not be able to do this and may actually develop the disease by having the vaccine which would be harmful.