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Important information about Dupixent and vaccines

Learn how to plan for necessary vaccines while being treated for eczema and other chronic conditions
Sarah Bradley writer headshot
By | Sep. 17, 2024 Medically reviewed by Jesse P. Houghton, MD, FACG
A syringe and vial: Important information about Dupixent and vaccines

Key takeaways

  • Dupixent is a biologic medication often prescribed for the treatment of severe eczema.

  • Because Dupixent is an immunomodulator, it lessens the immune response to triggers, meaning it can also affect how your body responds to certain vaccines.

  • Generally, people taking Dupixent should avoid live-attenuated vaccines containing small, weakened amounts of the disease it’s designed to prevent. Most other types of vaccines, including seasonal flu shots and COVID-19 vaccines, are considered safe.

  • If you need a live vaccine while taking Dupixent, contact your healthcare provider, as they may recommend stopping Dupixent for a period of time in order to safely receive the vaccine.

In this article:

If you have severe eczema, your dermatologist may have talked to you about taking Dupixent (dupilumab) to help manage your symptoms. Dupixent is a biologic medication, which means it’s manufactured in a lab using living tissue. Its most common use is for the treatment of severe eczema (atopic dermatitis) in adults and children 6 months and older, but it’s also approved by the Food and Drug Administration (FDA) to treat asthma, chronic rhinosinusitis with nasal polyposis, prurigo nodularis, and eosinophilic esophagitis (EoE) in certain people.

Dupixent works by moderating the immune system—and that can interfere with how your body responds to certain vaccinations. Here’s why, along with which vaccines you can get and what to do if you’re on Dupixent and need a live vaccine.

How Dupixent works in the body

“People with autoimmune diseases have an immune system that essentially overreacts to certain triggers,” says Jody A. Levine, MD, dermatologist at Plastic Surgery & Dermatology of NYC, PLLC in New York City. That heightened response leads to chronic inflammation. For someone with atopic dermatitis, this inflammation can cause dry skin, severe itching, and painful rashes. 

According to Geeta Yadav, MD, dermatologist and founder of FACET Dermatology, Dupixent works by blocking the signals of two specific proteins responsible for moderating the body’s immune response: interleukin-4 (IL-4) and interleukin-13 (IL-13). This allows the drug to lower your body’s immune response without totally suppressing it, reducing inflammation so you have fewer flares and improved symptoms.

Can you get vaccinated while taking Dupixent?

You can receive some types of vaccines while taking Dupixent, but not all. Live-attenuated vaccines—vaccines that use a weakened form of the germ that causes the actual disease—are generally not considered safe to receive on Dupixent. Most other types of vaccines, though (including the seasonal flu shot and the newer mRNA vaccines for COVID-19), don’t carry the same risk. 

Dupixent and live vaccines

“Live vaccines are generally safe for people with a healthy immune system,” says Dr. Levine. Examples of live vaccines routinely given to children and adults in the United States include those for measles, mumps, and rubella (MMR), rotavirus, and chickenpox. They don’t make you sick, but they do typically create lifelong immunity against these diseases because of the immune response they provoke.

Because Dupixent is an immunomodulator, it changes your body’s immune response so it is less overactive. That can also change how your body responds to a live vaccine. 

“Since Dupixent is designed to tone down the immune system, the risk is that your body won’t fight off the live vaccine as effectively, potentially leading to complications [including] developing a serious infection from the vaccine itself,” says Dr. Levine.

Dupixent and COVID-19 vaccines

There are two types of COVID-19 vaccines—inactivated and mRNA. Inactivated vaccines contain a killed form of the disease they’re designed to prevent, while mRNA vaccines use proteins to initiate an immune response to that disease. “But neither type of vaccine contains live pathogens,” says Dr. Levine, so all COVID-19 vaccines are considered safe with Dupixent.

COVID-19 vaccines and their booster shots are still new, and researchers are continuing to learn about how they interact with chronic conditions and different medications. But so far, the evidence is positive. For example, a recent study comparing the effects of COVID-19 vaccination on people with atopic dermatitis “found no significant difference in adverse reactions between the people taking Dupixent and the people taking other common eczema medications,” notes Dr. Yadav. 

Dupixent and flu vaccines

The seasonal flu shot is an inactivated vaccine and poses no risk to people on Dupixent. In fact, it might even be unwise to consider skipping it. “Given the high rates of seasonal influenza infection—especially in pediatric patients—as well as complications associated with the flu, I recommend it to all my patients with chronic diseases like atopic dermatitis and who are on Dupixent,” says Dr. Yadav.

How to schedule vaccines while taking Dupixent  

If you’re taking Dupixent and need to get any type of inactivated vaccine—whether it’s a seasonal flu shot, tetanus booster, or COVID-19 immunization—you likely won’t need to do anything differently. These vaccines haven’t been shown to pose a risk to people on Dupixent, though Dr. Levine says it’s always a good idea to discuss any vaccine with your healthcare provider if you’re on medications like Dupixent. “They can provide personalized advice based on your medical history and current treatment plan, ensuring that your immune system is well-equipped to handle the vaccine without unnecessary risk.”

If you need to receive a live vaccine while on Dupixent, you definitely need to consult with your healthcare provider first. Dr. Yadav says the ideal way to schedule live vaccines around Dupixent is to get the live vaccine first and wait four weeks before starting treatment with Dupixent. But this isn’t always possible. In the case of childhood vaccinations, for example, live vaccines are given on a schedule designed to work with a child’s immune system and provide maximum protection against illness when they need it most. Current guidelines recommend that pediatric patients complete their full course of live vaccinations before starting treatment with Dupixent, unless they need to begin treatment right away.

“But healthcare providers have to consider vaccination timing on a case-by-case basis,” says Dr. Yadav, “weighing the risks against the benefits.” A literature review published in 2021 confirms there’s not enough evidence about the safety of live vaccines in people taking Dupixent to establish any guidelines about how they should be administered. Although there have not been many adverse reactions observed in studies, the recommendation is still to avoid combining live vaccines with Dupixent whenever possible.

Dupixent (dupilumab) alternatives 

Dr. Levine says there are other medications that can be used to treat conditions like eczema and asthma that don’t interact with live vaccines. You and your healthcare provider will have to work together to determine whether these other medications can effectively treat your symptoms.

“Traditional treatments like topical steroids or nonbiologic medications may be used either temporarily or permanently, depending on your condition and how well you respond to treatment,” Dr. Levine explains. “Some people also explore nonpharmacological approaches, such as lifestyle changes, dietary modifications, or other complementary therapies.”

Common alternatives to Dupixent include topical medications like Eucrisa and Elidel, and nonbiologic medications such as Cibinqo and Rinvoq.