Is it safe to recieve a ‘flu shot’ when I'm taking immunosuppressant medications for my hair condition?

Patients with hair diseases that cause extensive hair loss, including advanced alopecia areata, or certain types of scarring alopecias (i.e. lichen planopilaris or discoid lupus) require oral medications to treat their hair loss. Hair loss in these patients can not be managed simply with topical lotions and creams and medications such as hydroxychloroquine, cyclosporine, mycophenolate mofetil and sulfasalazine are frequently prescribed.

At this time of year, many patients taking these immunosuppressants ask a similar question... is it safe to get a flu shot when I'm taking an immunosuppressant drug?

To fully answer this question, let’s review the different types of vaccinations. There are two main types of vaccinations that people can receive – “inactivated” vaccines (like the flu shot, hepatitis B vaccine, and HPV vaccine) and “live” vaccines (like measles, mumps and rubella vaccines, yellow fever vaccines and nasal spray flu vaccines).  In general, "inactivated" vaccines are safe for patients taking immunosuppressive medications. However, I advise all patients to review the specific details with their physician. For example, children under 6 months of age, those with egg allergy and those with a previous ‘bad’ reaction to the flu shot should not get the vaccine. In addition, "live" vaccines should not be given to patients taking immunosuppressive medications – and are best given before patients go on these drugs.

The main messages I tell my patients are:

Patients who take certain types of immunosuppressive medications may be at increased risk for certain infections and vaccines can help prevent many of these infections.

Inactive vaccines, like the flut shot, are generally safe and helpful in patients taking immunosuppressive medications 

Live vaccines should not be given to patients taking immunosuppressive medications