Quick Take‑Home
Before starting Cosentyx (secukinumab) you’ll want to:
| Vaccine | Why it matters | Timing relative to Cosentyx |
|---------|----------------|-----------------------------|
| Influenza (flu) | Prevents a potentially severe infection when your immune system is dampened | At least 2 weeks before the first dose |
| Pneumococcal (PCV13 → PPSV23) | Reduces risk of pneumococcal pneumonia/meningitis | PCV13 first, then PPSV23 8 weeks later, and again ≥ 2 weeks before Cosentyx |
| Shingles (Shingrix, recombinant zoster vaccine) | Secukinumab lowers CD4‑T cell function → higher shingles risk | Two doses, 2–6 months apart; ≥ 2 weeks before first Cosentyx |
| COVID‑19 (series + booster) | High‑risk for severe COVID when immunosuppressed | Complete series/booster ≥ 2 weeks prior |
| Tdap / Td (tetanus, diphtheria, pertussis) | Routine adult booster | Within 12 months, ideally ≥ 2 weeks before |
| Hepatitis B (if at risk) | Prevents chronic infection | 2–3 doses, finish ≥ 2 weeks before |
Live‑attenuated vaccines (e.g., MMR, varicella, live zoster, yellow fever) should NOT be given within 4 weeks before, during, or after starting Cosentyx. Shingrix is non‑live, so it’s safe and highly recommended.
---
Why Vaccinations Matter With Cosentyx
- Secukinumab blocks interleukin‑17A, a key cytokine in mucosal immunity.
- It lowers your body’s ability to fight bacterial, viral, and fungal infections.
- A well‑vaccinated patient is less likely to get severe infections that can interrupt therapy or lead to hospitalization.
---
Step‑by‑Step Prep Checklist
1. Gather Your Immunization Record
- Look for the dates of the last flu shot, pneumococcal shots, Shingrix, COVID‑19 doses, and Tdap/Td.
- If any are missing or you’re unsure, a quick phone call to your pharmacist or primary‑care office can fill the gaps.
2. Schedule Missing Vaccines
- Flu: If you haven’t had this year’s shot, do it ASAP.
- PCV13 → PPSV23: If you only have PCV13, get PPSV23 at least 8 weeks later; if you’ve had PPSV23 before PCV13, give PCV13 first.
- Shingrix: 2 doses, 2–6 months apart.
- COVID‑19: Complete the latest recommended series/booster.
3. Check for Live Vaccines
- If you need an MMR or varicella booster, do it ≥ 4 weeks before starting Cosentyx, and wait ≥ 4 weeks after the last dose of the biologic.
4. Get a Final “Vaccination‑Ready” Confirmation
- Your rheumatologist or dermatologist will review your immunization status before prescribing.
- They may want to see proof of immunity (antibody titers) for certain diseases (e.g., varicella IgG).
5. After Starting Cosentyx
- Live vaccines are contraindicated for at least 6 months after starting the drug.
- Inactivated vaccines can be given anytime; however, you might want to wait until the first dose of Cosentyx to ensure optimal immune response.
---
Common Questions
| Question | Short Answer |
|----------|--------------|
| Can I get a flu shot while on Cosentyx? | Yes, it’s safe and recommended. |
| What about a booster for shingles after I start Cosentyx? | No live vaccine; only Shingrix (already completed). |
| Do I need a hepatitis B booster? | Only if you’re at high risk (IV drug use, MSM, healthcare worker, etc.). |
| Is the COVID‑19 booster safe on biologics? | Yes, especially the mRNA or recombinant protein shots; avoid live‑attenuated ones (none are available for adults). |
| Do I need a meningococcal shot? | If you’re in a high‑risk group (e.g., complement deficiency) or travel to a region with high incidence. |
---
Resources & References
- American College of Rheumatology (ACR) 2024 Biologic Vaccination Guidelines – https://www.rheumatology.org/Practice-Quality/Clinical-Support/ACR-Guidelines/Immunizations
- CDC Immunization Schedules for Adults – https://www.cdc.gov/vaccines/schedules/adult.html
- FDA Cosentyx (secukinumab) Label – “Immunologic Reactions” – https://www.fda.gov/drugs/postmarket-drug-safety-communications
- ACIP (Advisory Committee on Immunization Practices) Recommendations – https://www.cdc.gov/vaccines/acip/
---
Bottom Line
Make sure you’re fully protected with influenza, pneumococcal, shingles (Shingrix), COVID‑19, and routine adult vaccines before you begin Cosentyx. Avoid live vaccines for at least four weeks before, during, and for a period after starting the biologic. Once your doctor gives the green light, you’ll be well‑armed against infections while enjoying the benefits of your new psoriasis treatment.
If you’re unsure about any vaccine or have special circumstances (pregnancy, travel, underlying disease), chat with your healthcare team—they’ll tailor the plan to your needs.