Vaccinations for RA Patients

Vaccinations are an important consideration for patients with autoimmune forms of arthritis such as Rheumatoid Arthritis.

Care has to be taken with vaccinations because these diseases are autoimmune disorders (i.e. they are related to problems with the immune system), and in addition, many of the medications used to treat them work by suppressing the immune system to a certain degree. While care has to be taken, vaccinations are important because they can help protect patients with weakened immune systems avoid getting sick with serious infections.

We recommend that patients always discuss all vaccinations with their doctor. Depending on a person’s disease and medications, some vaccines (e.g. the flu shot) are generally very safe for people to get any time, while others (e.g. “live” vaccines) can only be safely administered under certain conditions, and must be coordinated with a doctor.

Watch rheumatologist Dr. Nicole LeRiche explain which vaccines are safe, and precautions that should be taken in patients with RA:

Vaccination Guide

Our PDF vaccination guide for patients outlines which vaccines are safe for RA patients, and under what circumstances.

Interactive Form

The following interactive form was featured on our older website. Input your sex, age, and if you are taking biologics and/or DMARDs into the pop-over to learn which vaccines are recommended for you.

Herpes Zoster (Shingles) Vaccine Information

More information on the Herpes Zoster (Shingles) vaccine for RA patients:

  • A single lifetime dose
  • Recommended for individuals over the age of 60 but can be given to those between the ages of 50-59
  • Vaccination results in a 50% reduction in herpes zoster (perhaps 40% in RA patients)
  • Vaccination results in a 66% reduction in post-herpetic neuralgia
  • Where possible give 4 weeks prior to the initiation of biologic therapy
  • Most would give this vaccine to patients receiving low dose prednisone (<20 mg/day)
  • There is less data but it may be given to patients on low dose immunosuppression such as low dose methotrexate (<0.4 mg/kg/week) or azathioprine (<3 mg/kg/day)
  • The effectiveness of this vaccine in patients who have had shingles is not known. Should be given 1 year after last shingles outbreak.