The reason why you should avoid live vaccines with biologics is because the live vaccine when taken with biologics can potentially cause you to get the disease that it was designed to prevent.
Also an immune system that is weakened by immunosuppressant medicine may not mount the proper response to a vaccine.
People who should not receive a live virus vaccine are people who are pregnant, are severely immunocompromised and people that have any history of severe allergic reaction to vaccine components.
If you have conditions that significantly weaken your immune system, like HIV/AIDS, lymphoma, leukemia, or if you're undergoing chemotherapy or radiation treatment you should also avoid live virus vaccines.
Or if you're taking high doses of immunosuppressive drugs such as biologics or corticosteroids you should avoid live virus vaccines.
Also if you have conditions like Wiskott Aldrich syndrome, ataxia telangiectasia, or X linked lymphoproliferative disease you may also need to avoid live virus vaccines and if you have recently received any immunosuppressive therapy within the past 12 months you should avoid live virus vaccines.
And if you're on dupilumab you should also not receive a live virus vaccine.
Live vaccines should not be given to patients on dupilumab due to the potential for an increased risk of infection as well a potential impaired immune response.
Live vaccines are a concern when people are on dupilumab because dupilumab is an immunomodulator which means that it can affect your body's immune response.
As a result, there's also a theoretical risk that live vaccines which contain weakened versions of a bacteria or virus may not elicit the desired immune response or that the patient on dupilumab could be more susceptible to infection from the vaccine itself.
Examples of live vaccines that should be avoided in patients on dupilumab are the vaccines for mumps, measles, rubella, chickenpox, rotavirus, yellow fever and typhoid fever.
The vaccines include the MMR vaccine, varicella vaccine, FluMist "nasal spray flu vaccine.
However when a patient is on dupilumab, inactivated vaccines are generally safe.
Inactivated vaccines use killed versions of the viruses or bacteria and are generally considered to be safe in patients that are on dupilumab.
However if a live vaccine is deemed medically necessary then it's crucial to discuss the risks and benefits with a doctor who may recommend that you delay dupilumab treatment or other strategies to ensure safe vaccination when needed.