Table 3 Summary of data for vaccine efficacy and safety with immunomodulatory therapies
Drug | Protein vaccines | Carbohydrate vaccines | DTH/cellular immunity | Neoantigen | Live virus |
|---|---|---|---|---|---|
Non-biologic immunomodulators | |||||
Corticosteroids | --/↓ | -- | ND | ND | Zoster OK with CCS <20 mg/day |
Methotrexate | ↓↓ | ↓ | -- | -- | Zoster OK with MTX <0.4 mg/kg/week |
Anti-malarials | -- | -- | ND | ND | Probably safe, possible ↓ response |
Sulfasalazine | --/↓ | ND | ND | ND | Probably safe, not formally studied |
Leflunomide | -- | ND | ND | ND | ND |
Azathioprine | -- | --/↓ | ND | ND | Zoster OK <3 mg/kg/day |
Mycophenolate | ↓↓ | ↓↓ | ↓ | ↓ | Avoid |
Calcineurin Inhibitors | --/↓ | ND | ↓ | ND | Avoid |
Biologicals and targeted immunomodulators | |||||
TNF inhibitors | --/↓ | --/↓ | -- | ND | Avoid |
Abatacept (CTLA4-Ig) | ↓ | ↓ | ND | ↓ | Avoid |
Rituximab (anti-CD20) | --/↓ | ↓↓ | ↓ | ↓↓ | Avoid |
Tocilizumab (anti-IL6) | -- | -- | ND | ND | Avoid |
Ustekinumab (anti-IL-12/23) | -- | -- | ND | ND | Avoid |
IL- 1 inhibitors (anakinra, Rilonacept, canakinumab) | ND | ND | ND | ND | Avoid |
Belimumab (anti-BLyS) | ND | ND | ND | ND | Avoid |
Tofacitinib (Jak1/3) | --/↓ | ↓ | ND | ND | Avoid |