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Live vaccine before biologic — SCE Rheumatology MCQ

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HardRheumatological pharmacologyLive vaccine before biologicSCE Rheumatology

A patient without varicella immunity is likely to start biological treatment for psoriatic arthritis. What vaccination principle is appropriate?

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Correct answer: E — Give indicated live varicella vaccine before immunosuppression

The best answer is “Give indicated live varicella vaccine before immunosuppression”. Live vaccine should be planned before clinically significant immunosuppression, with timing based on the vaccine and medicine and specialist advice when treatment cannot wait. Giving it during or immediately after starting a biologic may cause vaccine infection; inactivated vaccines remain non-live, and antibiotics do not create varicella immunity.

Reference: UK Green Book immunisation guidance: https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book