Table 1.

Inactivated vaccines

VACCINE TYPE	INDICATIO N	REPEAT VACCINATION	SPECIAL CONSIDERATIO N	SAFETY CONCERN S
PNEUMOCOCCA L VACCINE	All previously un-immunized patients.	A dose of PPSV 23 should be repeated in 5 years.	PPSV-23 should be administered atleast 8 weeks following PCV −13.	Well tolerated. Conjugate ( PCV −13) vaccine not tested in SLE patients.
INFLUENZA VACCINE	Yearly during Flu season.	No data. Patients generally develop lower antibody response. May have inadequate protection.	None	May develop auto- antibodies, with no clinical significance.
HEPATITIS B	All previously unimmunized patients. Patients with risk factors like household contacts, health care worker, IV drug use, multiple sexual partners.	Check titers every year after initial series is completed. Booster vaccination to be given for low titers.	Additional dose after one month of complete series if there is inadequate antibody response.	No evidence for increased disease activity.
DIPTHERIA AND TETNUS TOXOID	19–64 years – single dose of Tdap as booster of last dose of Td>10 years	Booster for protection against pertsussis if interval is shorter than 10 yrs since last Td	Consider booster in patients with skin laceration/ soiled wounds. Adults <65 years should receive a single dose of Tdap if anticipating contact with infant < 12 months of age	No evidence for increased disease activity.
HAEMOPHILIS INFLUENZAE TYPE B	All previously un-immunized patients	No data.	None	No evidence for increased disease activity.
RABIES VACCINE	Pre and post exposure prophylaxis	Check titers to ensure adequate response if patient is on chloroquine, steroids or other immunosuppressiv e	Avoid activities requiring pre- exposure prophylaxis.	No evidence of increased disease activity
HPV VACCINE	All previously unimmunized individuals starting around 11–12 years of age ( earliest at 9)through 21 for males and 26 for females	Good seroconversion rate. No need for booster.	None	No evidence of increased disease activity