How should you manage your vaccinations when you have lupus?

During lupus, vaccinations are most often recommended, but with some precautions.

Getting vaccinated should be avoided as much as possible during a flare of the disease but is possible if necessary.

In case of long-term corticosteroid therapy, greater than 10 mg per day of prednisone, and especially in case of immunosuppressive therapy, live attenuated vaccines are contraindicated because of the risk of a strong reaction to the vaccine (the vaccine against yellow fever, varicella zoster, rubella, measles and mumps). Oral polio and BCG vaccines, which are also live vaccines, are never recommended in adulthood.

Taking corticosteroids, and especially immunosuppressants, may decrease the effectiveness of vaccines, but do not contraindicate their use (except in the case of live attenuated virus vaccines).

Some vaccines are strongly recommended, especially if there is an immunosuppressive treatment prescribed for a long time: vaccination against COVID-19, influenza vaccination, pneumococcal vaccination.

Since papillomavirus infections are more common in lupus patients, young lupus boys and girls may be offered HPV vaccination ideally before initial sexual relations.

Much has been said about the risk of the occurrence or onset of lupus, or other autoimmune diseases, after vaccination with the hepatitis B vaccine. Epidemiological studies have not confirmed the existence of a definite link. If for occupational reasons, or risk of exposure, vaccination against hepatitis B is necessary, it is possible. However, sometimes more injections will be needed to provide sufficient vaccination coverage.


> Updating the vaccination record is essential for lupus patients because they are at higher risk of infection

> Live attenuated vaccines are contraindicated when taking immunosuppressants or long-term corticosteroids (BCG, yellow fever, oral polio, measles, rubella, mumps)

> The pneumococcal, influenza and COVID-19 vaccine should be routine in lupus.

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