Inactivated Vaccine Safety Immunosuppressed CKD — ESENeph MCQ

Correct answer: E — Give inactivated influenza vaccine during azathioprine treatment

The best answer is “Give inactivated influenza vaccine during azathioprine treatment”. Immunosuppression may blunt vaccine response but does not make inactivated vaccination unsafe; product selection and timing should follow the Green Book and specialist treatment plan. “Withhold influenza vaccination throughout azathioprine treatment” is less appropriate because inactivated vaccines cannot replicate and are generally safe “Give live attenuated nasal influenza vaccine during treatment” is less appropriate because live vaccine is generally contraindicated during significant immunosuppression “Stop azathioprine for one month before inactivated vaccination” is less appropriate because routine abrupt interruption is not required and can destabilize disease “Defer influenza vaccination until maintenance dialysis begins” is less appropriate because risk-based vaccination applies before kidney failure

Reference: UK Green Book: immunisation of people with underlying medical conditions: https://www.gov.uk/government/publications/immunisation-of-individuals-with-underlying-medical-conditions-the-green-book-chapter-7