Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases

Table 3

Live vaccines during immunosuppressive therapy [40].

Therapeutic agent	Herpes zoster/varicella vaccination	Mumps, measles, rubella (MMR), yellow fever vaccination
Low-dose systemic or topical corticosteroids: (i) Short- or long-term daily or alternate-day therapy with <20 mg prednisone or equivalent; (ii) Glucocorticosteroid replacement therapy in adrenal insufficiency/topical steroids (airways, skin, ears, or eyes); (iii) Intra-articular, bursal, or tendon injection of steroids; Sulfasalazine; Hydroxychloroquine	No restrictions	No restrictions
Methotrexate	≤0.4 mg/kg/week (≤20 mg/week): vaccination possible	≤0.4 mg/kg/week (≤20 mg/week): vaccination possible
Azathioprine	≤3.0 mg/kg/day: vaccination possible; >3.0 mg/kg/day: contraindication	Contraindication
6-Mercaptopurine	≤1.5 mg/kg/day: vaccination possible; >1.5 mg/kg/day: contraindication	Contraindication
Abatacept	Contraindication	Contraindication
Adalimumab
Anakinra
Certolizumab
Cyclosporine A
Cyclophosphamide
Etanercept
Golimumab
High-dose systemic steroids (≥20 mg per day of prednisone or equivalent for more than 2 weeks)
Infliximab
Leflunomide
Mycophenolate mofetil; Rituximab
Tacrolimus
Tocilizumab
Ustekinumab

Table reproduced with permission from Swiss Medical Weekly—an open access publication of EMH published in accordance with the terms of the Creative Commons Licence Attribution-NonCommercial-NoDerivatives 4.0 International.