Mavenclad (cladribine) is a medication primarily used to treat relapsing forms of multiple sclerosis (MS). It works by selectively targeting and reducing certain immune cells, specifically lymphocytes, which play a role in the autoimmune process that damages the nervous system in MS. Because Mavenclad suppresses the immune system, its interaction with vaccines, especially live or attenuated vaccines, is an important consideration.
Mavenclad should generally **not be taken with live vaccines** or certain other vaccines that rely on a live or weakened form of the virus or bacteria. This is because the immune suppression caused by Mavenclad can reduce the body’s ability to respond properly to these vaccines, increasing the risk of infection from the vaccine itself or reducing vaccine effectiveness. Examples of vaccines that should be avoided during Mavenclad treatment include live vaccines such as BCG (for tuberculosis), yellow fever, measles, live influenza vaccines, and some COVID-19 vaccines that are live or live-attenuated.
Inactivated or non-live vaccines, such as the standard flu shot (non-live), pneumococcal vaccines, or hepatitis B vaccines, may be safer to administer, but timing is crucial. It is usually recommended to complete any necessary vaccinations **before starting Mavenclad treatment** or to wait until the immune system has sufficiently recovered after treatment before receiving vaccines. This is because Mavenclad causes a reduction in lymphocytes, which are essential for mounting an effective immune response to vaccines.
The immune suppression caused by Mavenclad also increases the risk of infections in general, including serious bacterial, viral, fungal, and parasitic infections. Because vaccines work by stimulating the immune system, the suppressed immune state during and shortly after Mavenclad treatment can blunt vaccine responses and increase vulnerability to infections that vaccines aim to prevent.
Doctors typically recommend the following approach regarding vaccines and Mavenclad:
– **Before starting Mavenclad:** Patients should be evaluated for their vaccination status. Any needed live vaccines should be administered at least 4 to 6 weeks prior to beginning Mavenclad to allow the immune system to respond adequately.
– **During Mavenclad treatment:** Live vaccines are contraindicated. Non-live vaccines may be given cautiously but often are deferred until after treatment cycles are completed and immune recovery is confirmed.
– **After Mavenclad treatment:** Vaccination may be resumed once lymphocyte counts have returned to safe levels, which can take several months. The timing depends on individual immune recovery and should be guided by a healthcare provider.
Because Mavenclad interacts with many medications and affects immune function, it is critical to discuss vaccination plans with a healthcare provider familiar with the patient’s treatment schedule and immune status. This ensures vaccines are given safely and effectively without increasing the risk of adverse effects or infections.
In summary, Mavenclad and vaccines, especially live vaccines, should not be taken simultaneously. Vaccination schedules should be carefully planned around Mavenclad treatment to maximize vaccine effectiveness and minimize risks. Non-live vaccines may be possible but require timing considerations based on immune suppression and recovery. Always consult a healthcare professional to tailor vaccination timing to individual treatment plans and immune status.
