In patients with rheumatoid arthritis, which vaccines are recommended to reduce infection risk?

• A. Meningococcal vaccine
• B. Influenza and pneumococcal vaccines
• C. Human papillomavirus vaccine
• D. Varicella vaccine (live)

Answer: (B)

Immunosuppressive therapy often used in rheumatoid arthritis increases the risk of infections, so protecting against the most common and serious culprits is essential. The best approach is vaccination with inactivated vaccines that reduce infection risk, especially against influenza and pneumococcus. Annual influenza vaccination helps prevent the flu and its complications, while pneumococcal vaccines reduce the risk of pneumonia and invasive pneumococcal disease, which RA patients are particularly vulnerable to. Live vaccines, like the varicella vaccine, are generally avoided in individuals on immunosuppressive therapy due to the potential risk of disseminated infection. Meningococcal and HPV vaccines aren’t routinely aimed at lowering infection risk specific to rheumatoid arthritis in the same targeted way as flu and pneumococcus.