Influenza Vaccination Guidance for Patients on Dupilumab

Key Recommendations

The American College of Cardiology and other guideline societies recommend that patients on dupilumab receive the inactivated influenza vaccine annually without interrupting treatment, as it is safe and effective 1, 2
The inactivated (intramuscular) influenza vaccine is recommended for all patients on dupilumab, while the live attenuated intranasal vaccine should be avoided, according to the MMWR Recommendations and Reports and the Journal of the American College of Cardiology 1, 3

Annual influenza vaccination is universally recommended for all persons aged ≥6 months, including those with chronic conditions, and should be administered each autumn, according to the MMWR Recommendations and Reports 1
The inactivated influenza vaccine should be administered each autumn to patients on any immunomodulatory therapy, with optimal timing from September through November, though vaccination should continue into January or later as long as vaccine is available, as recommended by the Journal of the American College of Cardiology and Gut 2, 3
The inactivated (intramuscular) influenza vaccine is non-infectious and safe for patients on immunomodulatory therapies, while the live attenuated intranasal influenza vaccine (LAIV) should be avoided, according to the Journal of the American College of Cardiology and Gut 2, 3

The inactivated influenza vaccine can be administered at any routine visit during flu season without interrupting dupilumab therapy, and there is no need to delay dupilumab doses or adjust the treatment schedule around vaccination, although this recommendation is based on a lower level of evidence from Praxis Medical Insights, a more authoritative source such as the Annals of the Rheumatic Diseases recommends avoiding confusion between dupilumab and traditional immunosuppressants like high-dose corticosteroids or rituximab 6