Can you get vaccinated while on Cosentyx?
Cosentyx (secukinumab), an IL-17A inhibitor for psoriasis, psoriatic arthritis, and ankylosing spondylitis, suppresses parts of the immune system. It does not broadly impair vaccine responses like live vaccines do with TNF inhibitors, but data shows mixed effects on antibody production.[1][2]
- Non-live vaccines: Generally safe and recommended. Studies indicate Cosentyx patients mount adequate responses to influenza, pneumococcal, and COVID-19 vaccines, though titers may be 20-50% lower than in healthy controls. Boosters help compensate.[3][4]
- Live vaccines: Contraindicated due to infection risk. Avoid MMR, varicella, yellow fever, and oral typhoid while on Cosentyx and for months after stopping.[5]
Timing vaccines around Cosentyx doses
Start vaccinations before initiating Cosentyx if possible, especially high-risk ones like shingles (Shingrix, non-live). Post-treatment, wait 4-6 months for live vaccines after last dose, per EMA/FDA guidance, as secukinumab's half-life is ~25-30 days.[6][7]
| Vaccine Type | Recommendation on Cosentyx | Evidence Notes |
|--------------|-----------------------------|---------------|
| Inactivated (e.g., flu, COVID-19, pneumococcal) | Safe; administer as scheduled | Reduced but protective responses in trials[3] |
| Subunit/recombinant (e.g., Shingrix, HPV) | Safe and preferred | Good immunogenicity preserved[4] |
| Live/attenuated (e.g., nasal flu, varicella) | Avoid | Theoretical dissemination risk[5] |
What studies say about immune response
Phase III trials and real-world data (e.g., from psoriasis registries) show Cosentyx reduces IgG responses to tetanus and pneumococcal vaccines by ~30%, but most patients achieve protective levels. COVID-19 vaccine studies post-2021 confirm seroconversion in 80-90% of Cosentyx users vs. 95%+ in untreated.[3][8] No increased breakthrough infections reported from vaccination itself.
Risks if you mix them anyway
Rare cases of disseminated varicella or zoster reactivation with live vaccines near biologic use, though less common with IL-17 inhibitors than JAK inhibitors. Monitor for infections; no vaccine-specific Cosentyx interactions like drug metabolism changes.[2][9]
Patient tips and doctor advice
Discuss with your rheumatologist or dermatologist—they may test antibody levels post-vaccination. Prioritize annual flu shots and pneumococcal for at-risk patients. Cosentyx does not affect COVID-19 vaccine efficacy enough to skip it.[4][10]
Sources
[1]: Novartis Cosentyx Prescribing Information (FDA)
[2]: EMA Cosentyx Summary of Product Characteristics
[3]: Furer et al., Lancet Rheumatol 2021 (vaccine responses in IL-17 inhibitors)
[4]: Kistner et al., J Am Acad Dermatol 2022 (COVID-19 vaccines in psoriasis biologics)
[5]: CDC/ACIP Guidelines on Immunization and Biologics
[6]: Keystone et al., Ann Rheum Dis 2017 (timing data)
[7]: Cosentyx HCP Site (Novartis)
[8]: Spohn et al., Rheumatology 2023 (psoriatic arthritis cohort)
[9]: Winthrop et al., Ann Rheum Dis 2015 (live vaccine risks)
[10]: American College of Rheumatology COVID-19 Vaccine Guidance