Can You Get Vaccinated If Your Immune System Is Compromised?

Discuss the pros and cons with your doctor

For people with compromised immune systems, getting vaccinated often involves complex decisions. A vaccine provides important protection to prevent illness, but when your system is weakened by conditions such as HIV or rheumatoid arthritis, does getting a vaccine also come with added risks? Before making that decision, talk to your doctor. And consider these things:

• What makes someone “immunocompromised”? Your immune system can be compromised in different ways. One example is an immunodeficiency, such as HIV. But other common autoimmune inflammatory diseases can weaken your immune system, too, including rheumatoid arthritis, Crohn’s disease, lupus and psoriasis. Medications also can play a part. Biologic drugs used to treat rheumatoid arthritis and similar conditions are designed to stop the immune system from malfunctioning.
• Which vaccines are risky? “Live” vaccines, including FluMist; those for shingles; measles, mumps and rubella (MMR) and yellow fever carry the biggest risk for immunocompromised patients. In people who aren’t immunocompromised, live vaccines gently poke the immune system, creating antibodies. But in someone with a compromised system, a live vaccine might lead to illness because of underlying problems with the immune system response—even, in some cases, causing the very disease it’s trying to protect against. If a patient’s disease might progress to the point of requiring biologic drugs in a few years, he or she might want to get vaccinated sooner rather than later.
• Are vaccines always on the no-fly list? Not necessarily. If you’re taking a biologic drug, for instance, current thinking says the shingles vaccine is off limits. But some studies suggest the vaccine may be safe for patients taking these drugs. Current clinical trial are underway to confirm whether that’s the case. This trial is evaluating the shingles vaccine in about 1,000 patients who are taking biologics. Final data from the trial is expected to be ready this fall. The bottom line: If you have a compromised immune system, talk to your medical team about risks and benefits specific to your condition. You and the team can then weigh your options.