Live Vaccines and Biologics — SCE Dermatology MCQ

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EasyDermatopharmacologyLive Vaccines and BiologicsSCE Dermatology

A 35-year-old woman with psoriasis controlled on a biologic is planning international travel. She needs a yellow fever vaccine. Can she receive this while on a biologic?

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Correct answer: C — No — yellow fever is a LIVE vaccine and is contraindicated during biologic therapy; she should receive it ≥4 weeks before starting a biologic or defer travel

Yellow fever vaccine is a LIVE attenuated vaccine and is therefore CONTRAINDICATED in patients on biologic therapy (and other significant immunosuppression). Live vaccines must be given ≥4 weeks before starting biologic therapy (to allow adequate immune response while not yet immunosuppressed) or deferred until an appropriate interval after biologic cessation (duration depends on the specific biologic's half-life). If the patient is already on a biologic and travel to a yellow fever zone is essential, a medical exemption letter for the yellow fever certificate may be needed. Other live vaccines contraindicated during biologics include BCG, MMR, varicella (Varilrix), oral typhoid, and oral polio.

Reference: BAD 2020 Biologic Guidelines; Green Book; NaTHNaC