Obinutuzumab recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. The CDC has stated that discontinuation of steroids for 1 month prior to live vaccine administration may be sufficient. Le BCG est un vaccin vivant atténué. Lenalidomide: (Severe) Live virus vaccines should generally not be administered to an immunosuppressed patient. Most children develop a sore at the injection site. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Amphotericin B-induced hypokalemia can result in interactions with other drugs. In adults, additional vaccine (1—2 drops) may be applied to assure a 'wet' vaccine site. Vinorelbine: (Severe) Do not administer live vaccines to vinorelbine recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving vinorelbine. Abatacept: (Severe) If possible, administer all needed vaccines before abatacept initiation. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Tacrolimus recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. Axicabtagene ciloleucel recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. Ozanimod: (Major) Avoid the use of live vaccines during ozanimod treatment and for up to 3 months after discontinuation of ozanimod treatment. The safety of immunization with live vaccines during or after emapalumab therapy has not been studied. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. Tositumomab recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. This is a slowed down version of giving the BCG vaccine to show technique. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Canakinumab: (Major) Do not administer live vaccines to a patient who is receiving canakinumab; other vaccination schedules should be complete as recommended prior to initiating canakinumab treatment. The immunosuppressive effects of steroid treatment differ, but many clinicians consider a dose equivalent to either 2 mg/kg/day or 20 mg/day of prednisone as sufficiently immunosuppressive to raise concern about the safety of immunization with live vaccines. Maximum dosage information is not available. In addition to the concerns with live virus vaccines, the immune response to inactive vaccines or toxoids may be decreased, as fingolimod may interfere with normal immune response to new antigens. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune syste Ethambutol: (Major) Urinary concentrations of ethambutol could interfere with the therapeutic effectiveness of BCG. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Siltuximab: (Severe) Do not administer live vaccines to siltuximab recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving siltuximab. CAUTION: Bacillus Calmette-Guerin (BCG) Vaccine, USP, contains live bacteria and should be prepared in a biological safety cabinet and handled using aseptic technique. If a patient with any of these conditions is accidentally vaccinated, an infectious disease specialist should be consulted and anti-tuberculin therapy given, if indicated. You should confirm the information on the PDR.net site through independent sources and seek other professional guidance in all treatment and diagnosis decisions. bTB a… Clofarabine: (Severe) Live virus vaccines should generally not be administered to an immunosuppressed patient. Urinary concentrations of these antibiotics could interfere with the therapeutic effectiveness of BCG. erythema nodosum / Delayed / Incidence not knownlupus-like symptoms / Delayed / Incidence not knownerythema multiforme / Delayed / Incidence not known, skin ulcer / Delayed / Incidence not knownlymphadenopathy / Delayed / Incidence not knownerythema / Early / Incidence not known, arthralgia / Delayed / Incidence not knownmyalgia / Early / Incidence not knowninfection / Delayed / Incidence not knownanorexia / Delayed / Incidence not knownfever / Early / Incidence not knowninjection site reaction / Rapid / Incidence not knownurticaria / Rapid / Incidence not knownrash / Early / Incidence not known. Blinatumomab: (Severe) Do not administer live vaccines to blinatumomab recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving blinatumomab. Before initiation of everolimus therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Saving Lives, Protecting People, The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices, TB Screening and Testing of Health Care Personnel, Diagnosing latent TB infection and TB disease, Deciding When to Treat Latent TB Infection, Treatment Regimens for Latent TB Infection (LTBI), TB Infection Control in Health Care Settings, Resources for TB Screening and Testing of Health Care Personnel, Interim Laboratory Biosafety Guidance for XDR, Model Performance Evaluation Program (MPEP), Rapid Molecular Testing to Detect Drug-Resistant TB in the US, Background on Tests for Molecular Detection of DR, General Considerations and Principles for a Molecular DR Testing Service, Possible Scenarios and Scope of Testing for a Molecular DR Testing Service, General Recommendations of the Expert Panel, The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TB, Reported TB in the US, 2019 Surveillance Report, Tuberculosis in the United States, 2019 (Slide Set), Archived Surveillance Reports and Slide Sets, Interactive Core Curriculum on Tuberculosis: What the Clinician Should Know, Effective TB Interviewing for Contact Investigation, LTBI: A Guide for Primary Health Care Providers, Report of Verified Case of Tuberculosis (RVCT), TB Contact Investigation Interviewing Skills Course, Understanding the TB Cohort Review Process, Tuberculosis – The Connection between TB and HIV, 12-Dose Regimen for Latent TB Infection-Patient Education Brochure, Tuberculosis Laboratory Aggregate Reports, Epidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016, Self-Study Modules on Tuberculosis, 1-5 Slide Sets, The Tuberculosis (TB) in Correctional Settings, Epidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017, Prevention and Control of Tuberculosis in Correctional and Detention Facilities, Guidelines for Preventing the Transmission of M. TB in Health care Settings, Investigation of Contacts of Persons with Infectious TB, Epidemiology of Pediatric Tuberculosis in the United States, Targeted Tuberculosis Testing and Treatment of Latent Tuberculosis Infection, Customizable Take on TB Infographic with Instructions, U.S. Department of Health & Human Services. Live virus vaccines should generally not be administered to an immunosuppressed patient. All equipment, supplies, and receptacles in contact with these products should be disposed of as biohazards. At least 6 weeks before initiation of tisagenlecleucel therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. BCG vaccine is contraindicated in patients with a hypersensitivity to any component of the vaccine including monosodium glutamate hypersensitivity and polysorbate 80 hypersensitivity; the vaccine is also contraindicated in patients with an anaphylactic or other allergic reaction to a previous dose of BCG vaccine. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Before initiation of obinutuzumab therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. (Major) Urinary concentrations of rifampin could interfere with the therapeutic effectiveness of BCG. This includes, but is not limited to, the reporting of events required by the National Childhood Vaccine Injury Act of 1986. Vaccination with live-attenuated or live vaccines is not recommended during treatment with ofatumumab; wait until B-cell recovery occurs after discontinuation of ofatumumab before administering these vaccines to a patient. Obinutuzumab: (Severe) Do not administer live vaccines to obinutuzumab recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving obinutuzumab. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Not a Member? Alemtuzumab: (Severe) Do not administer live vaccines to alemtuzumab recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving alemtuzumab. Paclitaxel: (Severe) Do not administer live vaccines to paclitaxel recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving paclitaxel. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Certolizumab pegol: (Severe) Do not administer live vaccines concurrently with certolizumab. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Before initiation of ifosfamide therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. Live vaccines should not be given concurrently with abatacept or within 3 months of its discontinuation. The CDC has stated that discontinuation of steroids for 1 month prior to live vaccine administration may be sufficient. The reduction in digoxin tablet absorption has resulted in plasma concentrations that are 50% of pretreatment levels and has been clinically significant in some patients. Live vaccinations may be less effective during ozanimod treatment and also may carry the risk of infection. Isoniazid, INH; Rifampin: (Major) Postpone instillation of BCG if the patient is receiving antibiotics, such as isoniazid. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. Ifosfamide recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. Live vaccines should not be given to individuals who are considered to be immunocompromised until more information is available. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Alefacept: (Severe) The safety and efficacy of administering attenuated virus vaccines or live vaccines to patients receiving alefacept have not been studied. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. No data are available on the response to live or inactive vaccines in patients receiving risankizumab therapy. Do not administer live vaccines to a ustekinumab recipient. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Emapalumab: (Major) Do not administer live or live attenuated vaccines to patients receiving emapalumab and for at least 4 weeks after the last dose of emapalumab. Amphotericin B-induced hypokalemia can result in interactions with other drugs. At least 2 weeks before initiation of cisplatin therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. to a friend, relative, colleague or yourself. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. To receive email updates about this page, enter your email address: Centers for Disease Control and Prevention. Consider VZV vaccination of antibody-negative patients before fingolimod initiation, and do not start fingolimod for 1 month to allow the full effect of vaccination to occur. Tacrolimus: (Severe) Do not administer live vaccines to tacrolimus recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving tacrolimus. Clarithromycin: (Major) Urinary concentrations of clarithromycin could interfere with the therapeutic effectiveness of BCG. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Kanamycin: (Major) Urinary concentrations of kanamycin could interfere with the therapeutic effectiveness of BCG. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. The CDC has stated that discontinuation of steroids for 1 month prior to live vaccine administration may be sufficient. BCG vaccine side effects. The BCG Vaccine is administered percutaneously with the multiple puncture disc for vaccination. BCG vaccine, vaccine against tuberculosis.The BCG vaccine is prepared from a weakened strain of Mycobacterium bovis, a bacteria closely related to M. tuberculosis, which causes the disease.The vaccine was developed over a period of 13 years, from 1908 to 1921, by French bacteriologists Albert Calmette and Camille Guérin, who named the product Bacillus Calmette-Guérin, or BCG. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Bacillus Calmette-Guerin (BCG) is administered percutaneously (BCG Vaccine, USP). Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Ustekinumab: (Severe) If possible, administer all recommended vaccines before ustekinumab initiation. (Major) Urinary concentrations of rifampin could interfere with the therapeutic effectiveness of BCG. Live vaccines should not be given to individuals who are considered to be immunocompromised until more information is available. Melphalan: (Severe) Do not administer live vaccines to melphalan recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving melphalan. Patients on corticosteroid treatment for 2 weeks or more may be vaccinated after steroid therapy has been discontinued for at least 3 months in accordance with general recommendations for the use of live vaccines. Do not filter. Further, in healthy patients, antigen-specific IgM titers were decreased by 25% in response to pneumococcal polysaccharide vaccine (PPV-23) immunization as compared with the response by placebo recipients. Bacillus Calmette-Guerin (BCG) is an immunostimulant that is used to stimulate the immune system to produce immunity against tuberculosis. Ecological evidence indicates that countries with national universal BCG vaccination programs for tuberculosis (TB) prevention have a much lower incidence of severe COVID-19 and mortality compared with those that do not have such programs. BCG vaccination has also been reported to have beneficial non-specific effects (NSE), in particular reducing all-cause infant mortality in certain settings. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Nelarabine: (Severe) Live virus vaccines should generally not be administered to an immunosuppressed patient. Do not prepare parenteral drugs in areas where BCG has been prepared. VACCIN COVID. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Tuberculin Purified Protein Derivative, PPD: (Major) Bacillus Calmette-Guerin Live, BCG administration may cause tuberculin purified protein derivative, PPD sensitivity. Cytarabine, ARA-C: (Severe) Do not administer live vaccines to cytarabine recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving cytarabine. Dupilumab: (Major) Avoid administration of live vaccines to dupilumab recipients. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Alemtuzumab recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Venetoclax: (Major) Avoid live vaccines to venetoclax recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving venetoclax. Auparavant, le vaccin était réalisé avec la fameuse bague, mais celle-ci … Vincristine: (Severe) Do not administer live vaccines to vincristine recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving vincristine. Of 1716 infant recipients of the TICE strain, 17 cases of tuberculosis occurred over 12—23 years after vaccination. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Sensitivity of the Connaught strain to several antibiotics was tested in vitro. Live vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. As tuberculin sensitivity is a valuable aid in the diagnosis of tuberculosis, determination of the tuberculin reactivity by PPD skin testing is advisable before BCG Live administration. Vaccination with BCG may cause a false positive reaction to a TB skin test. Use of the BCG vaccine is contraindicated in patients who are immunosuppressed, as immunosuppression may lead to clinical disease (see Adverse Reactions) and prevent an appropriate immune response to BCG vaccination. Cyclosporine: (Severe) Live virus vaccines should generally not be administered to an immunosuppressed patient. Docetaxel: (Severe) Do not administer live vaccines to docetaxel recipients; no data are available regarding the risk of secondary transmission of infection by live vaccines in patients receiving docetaxel. Amoxicillin; Clarithromycin; Omeprazole: (Major) Urinary concentrations of clarithromycin could interfere with the therapeutic effectiveness of BCG. No data are available on the response to live or inactive vaccines in patients receiving tildrakizumab therapy. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA. Positivity was defined as at least a 5 mm induration 48 hours after PPD testing. Lomustine, CCNU: (Severe) Live virus vaccines should generally not be administered to an immunosuppressed patient. Also, no data are available on the response to vaccination with any vaccine during baricitinib receipt. Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. The manufacturer recommends against use of the BCG vaccine during pregnancy. All rights reserved. TICE ® BCG is an infectious agent. No data are available on the response to live vaccination or on the risk of infection or infection transmission after the administration of other live vaccines to ustekinumab recipients. Before initiation of brodalumab therapy, consider completion of all age appropriate vaccinations per current immunization guidelines. Amphotericin B liposomal (LAmB): (Moderate) Administration of amphotericin B [lipid complex (ABLC), cholesteryl sulfate complex (ABCD), and liposomal (LAmB)] with antineoplastic agents may increase the potential for nephrotoxicity, bronchospasm, and hypotension. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. Position the patient's arm such that the deltoid muscle is parallel to the floor, presenting a flat surface for vaccine application.The vaccine dose is dropped from the syringe onto the skin. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule. This is a slowed down version of giving the BCG vaccine to show technique. Amphotericin B-induced hypokalemia can result in interactions with other drugs. Postpone instillation of BCG if the patient is receiving antibiotics. After 2 hours, discard solution and container as biohazards. The Bacillus Calmette-Guerin vaccine is still widely used in the developing world, where scientists have found that it does more than prevent TB. Live virus vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. Vinorelbine recipients may receive inactivated vaccines, but the immune response to vaccines or toxoids may be decreased. Digoxin: (Moderate) Some antineoplastic agents have been reported to decrease the absorption of digoxin tablets due to their adverse effects on the GI mucosa; the effect on digoxin liquid is not known.