Vaccination Guidance for Patients on Immunosuppressants

General Recommendations

The American College of Rheumatology recommends continuing methotrexate without interruption during the administration of non-live vaccines such as Adacel, Prevnar 20, and Abrisvo 1, 2
Methotrexate interruption is only recommended for influenza vaccination (2 weeks after vaccination), but not for other non-live vaccines 1, 3
The American College of Rheumatology recommends continuing Simponi (golimumab) without interruption during the administration of non-live vaccines 1, 2
No adjustment of the administration schedule is necessary for anti-TNF agents like Simponi during non-live vaccine administration 1, 4
Non-live vaccines such as Adacel, Prevnar 20, and Abrisvo can be safely administered to patients on immunosuppressants 1, 2

For patients taking the equivalent of prednisone ≤10 mg per day, administration of any non-live vaccine is strongly recommended 1, 5
For patients taking the equivalent of prednisone >10 mg but <20 mg per day, administration of non-live vaccines is conditionally recommended 1, 6
In contrast to Simponi and methotrexate, for patients on rituximab, it is recommended to plan non-live vaccinations (other than influenza) just before the next scheduled dose of rituximab, and then delay that dose by at least 2 weeks after vaccination 1, 2