Table 2.
Vaccine safety recommendations for immunocompromised patients*
| Inactivated or recombinant vaccines (generally safe on any DMT) | Live/attenuated vaccines mRNA vaccines† (Do not use while on [risk unknown, but specific DMTs as previously mentioned] theoretically safe) |
|---|---|
| Inactivated influenza vaccine | Live nasal spray influenza vaccine |
| Hepatitis A | Yellow fever |
| Hepatitis B | Measles, mumps, rubella (MMR) |
| Human papilloma virus (HPV) | Older varicella-zoster vaccine** |
| DTaP | Cholera |
| TD | Adenovirus |
| Inactivated polio vaccine | |
| Meningococcal vaccine | |
| Pneumococcal vaccine | |
| Rabies | |
| Varicella-zoster (Shingrix)** |
Table modified from Grebenciucova and Pruitt [45]
*Antibody response may be attenuated for patients on some disease-modifying therapies: two influenza vaccinations may be recommended
**Varicella-zoster required prior to alemtuzumab or fingolimod treatment and recommended, if possible, before ocrelizumab
†Timing of vaccination with respect to ocrelizumab infusion should be optimized to afford the best chance of a robust immune response (2nd dose > 2 weeks before next infusion)