Table 2.

Live Vaccine

VACCINE TYPE	INDICATION	REPEAT VACCINATION	SPECIAL CONSIDERAT ION	SAFETY CONCERNS
HERPES ZOSTER VACCINE	All previously unimmunized individuals. Await for at least 4 weeks before starting immunosuppressive treatment.*	Not indicated	May consider using new adjuvant recombinant vaccine as an alternative.	Limited studies published. No evidence of increased disease activity based on current evidence.
MEASLES- MUMPS- RUBELLA	Contra-indicated in patients on high doses of immunosuppressive medications.	Not indicated	Post-exposure therapy after exposure to Measles regardless of prior immunization status	No safety data is available
POLIO VACCINE	Unvaccinated immunocompromised adults should receive enhanced inactivated polio vaccine (eIPV)	Not indicated	Household contacts should receive enhanced inactivated polio vaccine (eIPV)	Patient may experience disease flare after inactivated or oral polio vaccine.

^*Current ACIP guidelines, allows Zostavax while patients are on Methotrexate (<0.4 mg/Kg/week), Azathioprine (<3.0 mg/Kg/day), or 6- mercaptopurine (<1.5 mg/Kg/day) or Prednisone: (<20 mg/day or <14 days).