Vaccine guidelines for:
- >18yo<65yo with rheumatic or musculoskeletal disorders on immunosuppression, AND
- Adults (≥ 65yo) with rheumatic and musculoskeletal disorder with or without immunosuppression
Recommended
- Pneumococcal conjugate vaccine (PCV15) followed 12 months later by polysaccharide vaccine (PPSV23), OR
- Single-dose PCV20
Recommended
- Two vaccination series
Recommended
- High-dose or adjuvanted preferred over regular-dose
- If on methotrexate, recommend holding for 2 weeks after vaccination
Recommended
- Age ≤45 yo and not previously vaccinated in childhood
Recommended
- 1 updated Pfizer-BioNTech or Moderna COVID-19 vaccine plus one additional dose of updated vaccine 2 or more months after 1st updated vaccine (4 or more months if not moderate to severely immunocompromised)
Includes: Intranasal influenza, MMR, rotavirus, typhoid, varicella, yellow fever, zoster
- HOLD immunosuppressive medication (view list of immunosuppression medications) prior to and after vaccination at discretion of rheumatologist
- Recommended if indicated based on patient age and/or history
Special considerations:
- Other than influenza vaccination, defer vaccinations until next Rituximab dose due and delay Rituximab dose for 2 weeks after vaccine administration
- For patients taking the equivalent of prednisone ≥20mg/d, defer vaccinations (except influenza) until tapered <20mg/d
- No contraindications to giving multiple vaccinations to patients on same day