Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases

Table 4

Vaccination schedule in IRD [58].

	Low immunosuppression	High immunosuppression
Influenza	1 dose annually
Pneumococcal (polysaccharide or conjugate)	1-2 doses
Tetanus, diphtheria (Td)	Booster every 10 years
Hepatitis B	3 doses, 0, 1 and 6 months; double doses in high-risk patients initiating bDMARDs or medium/high-dose corticosteroids, depending on serological status
Hepatitis A	2 doses of vaccine (0 and 6 months)
Varicella/herpes zoster	Considered in patients with inflammatory rheumatic disease. Administration should be 2–4 weeks prior to initiation of conventional synthetic DMARDs
Measles, mumps, and rubella (MMR)	Considered in mildly immunosuppressed patients on an individual basis
Meningococcal (quadrivalent conjugate meningococcal vaccine)	10 days before and up to 3 years before undertaking Hajj; Repeated every 5 years if hypo/asplenic state
Haemophilus influenza type B	1 dose
HPV	2 or 3 doses

Table reproduced with permission from the European Journal of Rheumatology.