NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Vaccines in Immunosuppressed Patients

The MHRA Drug Safety Update published in April 2016 reminds healthcare professionals of the risks of administering live attenuated vaccines to patients who are clinically immunosuppressed, either due to drug therapy or underlying illness. Case reports have identified elderly patients who have received shingles vaccine when they were possibly immunosuppressed and neonates who developed disseminated BCG or tuberculosis infection after exposure to a TNFα antagonist from the mother either in utero during pregnancy or via breastfeeding.




  • Live attenuated vaccines should not routinely be given to people who are clinically immunosuppressed (either due to drug treatment or underlying illness)
  • Healthcare professionals who are administering a particular vaccine should be familiar with the contraindications and special precautions before proceeding with immunisation
  • Specialists with responsibility for an immunosuppressed patient who may be in a group eligible for a live attenuated vaccine should include in their correspondence with primary care a statement of their opinion on the patient’s suitability for the vaccine
  • If there is any doubt as to whether a person due to receive a live attenuated vaccine may be immunosuppressed at the time, immunisation should be deferred for specialist advice
  • Close contacts of immunosuppressed individuals should be fully immunised to minimise the risk of infection of vaccine-preventable diseases in immunosuppressed individuals




Published 19/07/16