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Biologic Vaccination — SCE Dermatology MCQ

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HardDermatopharmacologyBiologic VaccinationSCE Dermatology

A non-immune adult is due to start biologic therapy for severe psoriasis. What vaccination principle should be applied before treatment begins?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Complete indicated vaccination and give required live vaccines before immunosuppression

The best answer is “Complete indicated vaccination and give required live vaccines before immunosuppression”. Live vaccines generally need to be completed before significant immunosuppression because they are subsequently contraindicated; the whole indicated vaccine history should be reviewed rather than naming one universal vaccine for every patient. The alternatives “Give every live vaccine during biologic treatment, when the full phenotype supports it”, “Withhold all inactivated vaccines indefinitely, within an appropriate UK pathway”, “Administer influenza vaccine as the sole required review”, “Start treatment first and review immunity after six months” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations