Dupixent and Vaccines: Live Vs Inactivated Vs COVID Vaccines

Dupixent is a biological medicine. It modulates T-cell immunity by targeting IL-4 and IL-13.

Because it blocks specific immune reactions, it makes a person prone to infections.

Likewise, live vaccines can become active and may result in full-blown disease.

Different Types of Vaccines:

A vaccine is a dead or weak germ (virus or bacteria) or a part of a germ that is administered to a person.

The person’s immune cells try to get rid of the germ after it enters the body. This process involves the activation of the person’s immune cells including memory B cells.

The memory B cells are the primary cells that remain in the body for a long time after the germ has been cleared of the body. These cells become active when a second encounter with the same germ is faced.

As memory cells are already there, when an infection occurs in a vaccinated person, the body can clear that infection more easily.

The strongest immune activation is provided by live attenuated vaccines. However, live attenuated vaccines put a person with weak immunity at risk of developing the disease. The same is the case when a person is using Dupixent, live vaccines can act like real infections.

There are six different types of vaccines that are used to enhance a person’s immunity against that specific disease.

These include [Ref]:

• Live attenuated Vaccines
• Inactivated Vaccines
• Polysaccharide conjugate vaccines
• mRNA vaccines
• Toxoid vaccines
• Viral vector vaccines

What are live attenuated vaccines?

Live attenuated vaccines, as the name suggests, are live germs that are slightly modified so as to make them weak enough to become harmless.

Live attenuated vaccines incite a strong immune response and hence are the most effective vaccines. However, in immune-deficient people, live vaccines should be avoided.

In immune-deficient patients and patients who are on Dupixent, the use of live vaccines is contraindicated.

Examples of live attenuated vaccines:

• Chickenpox vaccine
• Yello fever vaccine
• Oral Polio vaccine
• Smallpox vaccines
• Rotavirus vaccine, and
• MMR (measles mumps rubella vaccine)
• BCG vaccine

What are inactivated vaccines?

Inactivated vaccines are made up of killed germs. Thus, like live vaccines, inactivated vaccines can incite a strong immune response, however, multiple doses of the vaccines are usually required.

Inactivated vaccines are safe for use by people with impaired immunity and those on Dupixent treatment.

Examples of inactivated vaccines include:

• Inactivated polio vaccine (injectable vaccine)
• Whole-cell pertussis vaccine
• Rabies vaccine
• Hepatitis A vaccine
• Flu vaccines (Flu shots only)

Recombinant polysaccharide conjugate vaccines:

Recombinant polysaccharide conjugate vaccines are made of a specific part of a germ. These can be the outer capsule, a protein, or a sugar moiety of the germ.

Because these vaccines are not live or whole germs, they can be used safely by anyone including those with a weak immune system. These vaccines are safe for patients who are using Dupixent.

Examples of polysaccharide conjugate vaccines include:

• Pneumococcal vaccine
• Meningococcal vaccine
• Hib (Haemophilus influenza type b vaccine)
• Hepatitis B vaccine
• Whooping cough vaccine or acellular pertussis vaccine (DTaP)
• Shingles vaccine

mRNA vaccines:

mRNA vaccines have been used only to provide immunity against COVID-19 infections. These vaccines are not live organisms and hence can not cause disease in the person receiving the mRNA vaccine.

mRNA vaccines are considered safe for use in immunocompromised people including people who are on Dupixent.

Examples of mRNA vaccines:

• Pfizer-BioNTech COVID vaccine
• Moderna COVID-19 vaccine

Toxoid vaccines:

Toxoid vaccines are developed to provide immunity against the toxin released by bacteria. These vaccines are safe for use in immunocompromised patients and patients using Dupixent injections.

Examples of Toxoid Vaccines:

• Tetanus Toxoid Vaccine
• Diphtheria Toxoid vaccine

Viral vector vaccines:

Viral vector vaccines use a harmless virus as a vector that carries an immunogenic material of a harmful virus. Common viral vectors include adenovirus, VSV (vesicular stomatitis virus), and influenza virus.

Generally, viral vector vaccines should not be used in immunocompromised people and people who are on Dupixent therapy.

Example of a viral vector vaccine:

• AstraZeneca Vaxzevria COVID-19 vaccine
• Janssen (Johnson & Johnson) COVID-19 vaccine

Dupixent and Vaccines: Which vaccines are safe to use

Except for the live attenuated vaccines and vaccines that require a viral vector, all the other vaccines are safe to use by people using Dupixent.

Vaccines that are safe for use in people who are immunocompromised or are injecting Dupixent are listed below:

Inactivated vaccines include:

• Inactivated polio vaccine (injectable vaccine)
• Whole-cell pertussis vaccine
• Rabies vaccine
• Hepatitis A vaccine
• Flu vaccines (Flu shots only)

Polysaccharide conjugate vaccines include:

• Pneumococcal vaccine
• Meningococcal vaccine
• Hib (Haemophilus influenza type b vaccine)
• Hepatitis B vaccine
• Whooping cough vaccine or acellular pertussis vaccine (DTaP)
• Shingles vaccine

mRNA vaccines:

• Pfizer-BioNTech COVID vaccine
• Moderna COVID-19 vaccine

Toxoid Vaccines:

• Tetanus Toxoid Vaccine
• Diphtheria Toxoid vaccine

Dupixent and Live Vaccines: Avoid these vaccines

The following vaccines are live vaccines and should not be administered by people using Dupixent (Dupilumab):

• Chickenpox vaccine (Varicella Vaccine)
• Yello fever vaccine
• Oral Polio vaccine
• Smallpox vaccines
• Rotavirus vaccine, and
• MMR (measles mumps rubella vaccine)
• BCG vaccine

Dupixent and Viral Vector Vaccines: Avoid these COVID Vaccines

The following COVID vaccines are based on the technology using a live virus as a vector to transport COVID-19 viral components.

These vaccines should be avoided in patients on Dupixent treatment:

• AstraZeneca Vaxzevria COVID-19 vaccine
• Janssen (Johnson & Johnson) COVID-19 vaccine

Which COVID-19 vaccines are safe in patients using Dupixent?

COVID-19 vaccines that use mRNA can be safely used by people who are using Dupixent.

These mRNA vaccines are safe for use in patients using Dupixent:

• Pfizer-BioNTech COVID vaccine
• Moderna COVID-19 vaccine

In Summary:

Live attenuated vaccines and viral vector vaccines are unsafe for patients using Dupixent shots (Dupilumab injections).

It is important to know that not all COVID vaccines are safe for use in patients who are immunocompromised or are using Dupixent injections.

Furthermore, the Shingles vaccine and Varicella vaccines are two totally different vaccines.

The shingles vaccine is a polysaccharide vaccine and is safe in patients using Dupixent while the varicella vaccine is a live attenuated vaccine and is contraindicated in patients using Dupixent.