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Other Questions About JIA Medications

What about vaccinations?

We need vaccines to help prevent infections. JIA itself does not cause problems with the vaccines. However, JIA medications can reduce the protection a child will get from vaccines. Some JIA medications can limit the type of vaccine that a child can safely receive. It may be risky to take certain vaccines.

Drugs that are safe with ALL vaccines

NSAIDs, sulfasalazine, and hydroxychloroquine do not change the immune system. ALL ROUTINE VACCINES ARE SAFE. 

Drugs that are safe with SOME vaccines

Corticosteroids, methotrexate, leflunomide, cyclophosphamide, azathioprine, cyclosporine, and biologics DO change the immune system.

The FOLLOWING VACCINES ARE SAFE AND RECOMMENDED:

  • diphtheria, tetanus, pertussis
  • inactivated polio
  • pneumococcus (Prevnar or Pneumovax)
  • meningococcus (Menjugate, Menjutec, Menactra)
  • hemophilus influenza type B
  • influenza (flu) vaccine
  • hepatitis B vaccine and hepatitis A vaccine
  • Gardasil: the vaccine for human papillomavirus

The FOLLOWING ARE LIVE VACCINES. They are considered UNSAFE with these drugs. THESE VACCINES SHOULD NOT BE GIVEN until these medications have been stopped for at least one to two months:

  • measles, mumps, rubella
  • oral polio vaccine
  • varicella (chicken pox) vaccine
  • BCG (the vaccine for tuberculosis)
  • yellow fever

If you have any questions about the safety of a vaccine, ask the doctor or nurse.

What about complementary and alternative medicine?

Complementary and alternative medicines are therapies that are not prescribed by the regular health care team. These include prayer, meditation, therapeutic touch, acupuncture, vitamins, minerals, supplements, or naturopathic or homeopathic therapies. There are many reasons why some people use complementary and alternative medicine.

The therapies prescribed by the regular health care team are called conventional medicine. Complementary medicine is used together with conventional medicine. Alternative medicine is used in place of conventional medicine.

Important safety points for complementary and alternative medicine

  • Talk to the doctor about any complementary or alternative medicines that you are considering. These can interact with JIA medications. They can affect how the body responds to JIA medications. They may lead to more side effects.
  • Remember that the label may not reflect what is in the bottle. Some of these treatments have ingredients not listed on the label. They may have much more or much less of the featured ingredient than their label states.
  • Even though they may be �natural,� these treatments can have side effects too.
  • The claims for many of these treatments can be attractive. They can claim to help improve, or even cure, JIA. They can promise to make a child feel better. Much of the information about these treatments is based on personal stories from patients or alternative health care providers. Although some of these treatments may help, they have not been scientifically studied.
  • Check with the doctor to make sure these treatments do not interact with JIA medication. In many cases, the doctor cannot say for sure that there will be no interaction. Many of these treatments have never been studied.
  • Do not stop any prescribed medications. Instead, use these other treatments in addition to the regular medicines. Be sure the doctors or nurses know about any complementary treatments.
  • Some of these treatments may suggest restricting certain foods in the diet. Make sure no essential nutrients are being reduced or cut out. Children require many nutrients to grow and develop properly. For example, if a treatment suggests reducing dairy products, remember that children still need the calcium for healthy growing bones and teeth.

Adam M. Huber, MSc, MD, FRCPC

Michael A. Rapoff, PhD

Lynn Spiegel, MD, FRCPC

Jennifer Stinson, RN, PhD, CPNP

Gillian Taylor, MSc(A)

Shirley Tse, MD, FRCPC

Lori B. Tucker, MD

12/27/2009




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