MMR and varicella immunization during dupilumab therapy.
MMR and varicella boosters were often delayed in children on dupilumab
MMR and varicella immunization during dupilumab therapy.
The US Food and Drug Administration recommends deferring administration of live vaccines during dupilumab treatment owing to lack of data on safety and efficacy.
Our aim was to determine the safety of MMR and varicella immunizations during treatment with dupilumab and the impact of dupilumab on MMR and varicella vaccination rates in early childhood.
We performed a single-center retrospective review of children younger than 9 years who were taking dupilumab and had available vaccination records.
11.5% of MMR boosters were delayed because children were taking dupilumab.
Of the 19 patients who received MMR and varicella immunization while taking dupilumab, none experienced severe vaccine-associated events or vaccine-associated infections.
One patient reported fever and injection site reaction, and 5 reported a flare of atopic dermatitis (atopic dermatitis).
There was a significant delay in the age of administration of MMR boosters and varicella boosters when before- and after-dupilumab therapy rates were compared.
MMR and varicella immunization may be safe to administer to children undergoing dupilumab therapy. Pausing dupilumab therapy for administration of live vaccines may lead to flare of underlying atopic dermatitis.
Further, dupilumab treatment in early childhood may result in decreased and/or delayed vaccination rates for MMR and varicella.
Our findings support the recent recommendation that immunizations not be delayed while patients are receiving dupilumab.