"Live" vaccines contain a weakened version of the disease. It is possible for individuals with weakened immune systems (due to disease, long-term steroid use, or because of medications such as chemotherapy or biological drugs that intentionally weaken the immune system) to become ill after being exposed to a live vaccine. A "live" vaccine could unintentionally cause a mild case of the illness that it is intended to prevent.
List of Live Vaccines
(These are "Not OK" for those with weak immune systems):
• Influenza (Intranasal Mist): Don't be confused--the intra-nasal flu mist vaccine is live--this is the one that is squirted directly into the nose. (The injected flu vaccine ("flu shot") is an inactivated or "killed" vaccine and not usually dangerous.)
• Polio (Oral vaccine): Note, only the polio vaccine that is taken by mouth is live; the injected polio vaccine is now the vaccine of choice for most patients.
• Rotavirus (Oral and Injectable)
• Rubella (German Measles)
• Smallpox (Vaccinia): After vaccination the risk to persons with vulnerable immune systems is so great, that the vaccinated person is told not to have household or personal contact with pregnant women, infants, individuals with compromised immune systems until the vaccine scab has healed and fallen off. Check out the link for details.
• Typhoid (Oral vaccine): There is also a "killed" (inactive) injected version of the Typhoid Vaccine.
• Varicella (Chickenpox)
• Yellow Fever
• Herpes Zoster vaccine (Shingles)
• BCG (Tuberculosis): This vaccine is rarely given in the U.S.; however, it is still administered in Mexico and in Europe. (Please note this vaccine should NOT be confused with the TB skin test that is NOT a vaccine, but rather a screening test; the TB skin test, (PPD), is perfectly acceptable for anyone with a weakened immune system.)
List of Inactivated or "Killed" Vaccines
(These are OK for most patients):
• Influenza Injection ("Flu shot"): Note that the injection is a killed vaccine, but the nasal flu mist vaccine is a live vaccine.
• Haemophilus influenzae type b (Hib)
• Diptheria Toxiod (included in the DTAP vaccine)
• Tetanus Toxoid (Lock Jaw): Typically combined with the diptheria vaccine
• Pertussis (Whooping Cough)
• Polio (Injection)
• Hepatitis B
• Typhoid Injectable: Note that there is also an oral version of the Typhoid vaccine available which is "live." The link gives information about both versions of the vaccine.
• Meningococcal (Meningitis)
• Japanese Encephalitis (Adult) and Japanese encephalitis (Pediatric)
• Tick-Borne Encephalitis (TicoVac) (Not available in the U.S)
• Rabies (see also National Network for Immunization Information: Rabies)
• Pneumococcal polysaccharide vaccine (“Pneumonia Shot”)
Sources of Information for Vaccines:
• Vaccine Information Statements (VIS): Available in many languages.
• CDC Vaccine Information Statements: Available in an audio version and in Spanish
• National Vaccine Information Center
• National Network for Immunization Information