Table 6. Recommended timing of vaccination after discontinuing AIIRD treatment by the type of AIIRD medications.
| Drug category | Medication | Half-life period | Inactivated vaccine | Live attenuated vaccine |
|---|---|---|---|---|
| Glucocorticoid | Prednisone | 3 - 4 hours | No limitation to vaccinationa | 1 month |
| Synthetic DMARD | Methotrexate | 3 - 10 hours | No limitation to vaccinationa | 1 - 3 months |
| Leflunomide | 14 days | 3 - 24 months | ||
| Biologic DMARD | Etanercept | 4.3 days | No limitation to vaccinationa | 1 month |
| Adalimumab | 14 days | 3 months | ||
| Certolizumab | 14 days | |||
| Golimumab | 12 days | |||
| Infliximab | 8 - 10 days | |||
| Abatacept | 13 days | 3 months | ||
| Tocilizumab | 13 days | |||
| Rituximab | 21 days | 6 - 12 months | ||
aAlthough there is no limitation to vaccination, decisions should be made in consideration of the urgency of vaccination and the level of immunosuppression.
AIIRD, autoimmune inflammatory rheumatic disease; DMARD, disease-modifying antirheumatic drugs.