For a patient on infliximab, what immunization should be avoided?

For a patient receiving infliximab, it is essential to avoid live attenuated vaccines. The zoster vaccine, specifically the live attenuated form, is designed to stimulate an immune response using a weakened form of the varicella-zoster virus. Infliximab is a monoclonal antibody that suppresses the immune system, which can increase the risk of infections and diminish the effectiveness of vaccines, particularly those that are live.

When a patient is on infliximab, their immune response may be impaired, making it unsafe for them to receive live vaccines like the live zoster vaccine. On the other hand, inactivated vaccines, such as the influenza, COVID-19, and pneumococcal vaccines, are generally considered safe and can be administered as they do not pose the same risk of causing disease in immunocompromised individuals. Therefore, avoiding the live zoster vaccine is crucial to prevent potential complications that may arise from immunization while under immunosuppressive therapy.