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Vaccines for children with rheumatological conditions

Patient information A-Z

You have been given this leaflet as your child has been started on a medication which may have an impact on how we give your child vaccines. Vaccines are available as either live or non-live ‘killed’ vaccines. If your child is taking immunomodulating medication(s), they should avoid live vaccines unless advised by the paediatric rheumatology team on an individual basis.

Children on the following immunomodulating medications should not have live vaccines:

  • Methotrexate – unless advised by your rheumatology team.
  • Steroids (prednisolone, hydrocortisone) including up to four weeks after finishing the course.
  • Other DMARDs – mycophenolate mofetil, azathioprine, leflunomide.
  • Biological therapies – etanercept, adalimumab, tocilizumab, infliximab, anakinra, abatacept, rituximab, canakinumab, secukinumab, belimumab.
  • JAK inhibitors – baricitinib, tofacitinib.
  • Cyclophosphamide.

Additional information

  • Please note: if your child is on immunomodulating medication, they should avoid entering the area where live nasal flu spray vaccines are being administered (eg at school).
  • Household contacts (aged six months and over) of the person on immunomodulating medication are likely to be eligible to receive the yearly flu vaccination – please speak to your family GP about this.

Further advice

If you have any questions or concerns, please contact the paediatric rheumatology advice line between 08:00 (8am) and 16:00 (4pm) Monday to Friday on 01223 254988 or email the paediatric rheumatology team.

Current routine vaccinations in the UK

Diphtheria, tetanus, pertussis, polio, Hib, Hep B (DTaP/IPV/Hib/HepB)

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 8, 12, 16 weeks / 40 months

Meningococcal B (Men B)

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 8, 16 weeks / 12 months

Rotavirus

How is it given? Oral liquid (by mouth)
Live? Yes
Ok for children on disease modifying medications? No
Ages given: 8, 12 weeks

Pneumococcal vaccine (PCV13)

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 12 weeks / 12 months

Hib/Men C

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 12 months

Measles, mumps and rubella (MMR)

How is it given? One injection
Live? Yes
Ok for children on disease modifying medications? No
Ages given: 12 months / 40 months

Nasal flu vaccine (LAIV)

How is it given? Nasal spray
Live? Yes
Ok for children on disease modifying medications? No
Ages given: From 6 months with clinical risk or from 2 years if not on immunomodulating medication

Injectable flu vaccine

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: From 6 months with clinical risk or from 2 years if not on immunomodulating medication

COVID-19 seasonal vaccine

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: Eligible as per seasonal eligibility criteria

Human papillomavirus (HPV)

How is it given? One injection / Three separate injections if your child is on medication listed above
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 12 to 13 years; ask your child’s GP or school nurse if your child is eligible for x3 vaccines

Tetanus, diphtheria and polio (Td/IPV)

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 14 years

Meningococcal A, C, W, Y (MenACWY)

How is it given? One injection
Live? No
Ok for children on disease modifying medications? Yes
Ages given: 14 years

Varicella vaccine (chickenpox) *

How is it given? Two separate injections
Live? Yes
Ok for children on disease modifying medications? No
Ages given: * Not currently routinely given as a vaccination in the UK: we will check your child’s immunity level to chickenpox, give you the results and make a plan.

We are smoke-free

Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.

Other formats

Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/

Contact us

Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ

Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/