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PCP Prophylaxis — SCE Rheumatology MCQ

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HardRheumatology PharmacologyPCP ProphylaxisSCE Rheumatology

A patient with granulomatosis with polyangiitis is clinically stable and will receive rituximab in four weeks. Influenza and recombinant-zoster vaccines are due. Which vaccination plan is most appropriate?

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Correct answer: B — Give influenza and recombinant-zoster vaccines before the first rituximab infusion

Non-live vaccines are safe during immunosuppression but responses are generally better before B-cell depletion. When disease control permits, indicated influenza and recombinant-zoster vaccination should therefore be completed before rituximab; urgent organ-threatening treatment must not be delayed for vaccination.

Reference: 2025 BSR management recommendations for ANCA-associated vasculitis (Published June 2025): https://academic.oup.com/rheumatology/article/64/8/4470/8160140; UKHSA Green Book chapter 7: immunisation of people with underlying medical conditions (Current chapter, accessed 30 July 2026): https://www.gov.uk/government/publications/immunisation-of-individuals-with-underlying-medical-conditions-the-green-book-chapter-7