What are the recommendations for immunizations in patients taking BIMZELX (Bimekizumab)?

Immunization Recommendations for Patients Taking BIMZELX (Bimekizumab)

Patients taking BIMZELX (bimekizumab) should receive all age-appropriate inactivated vaccines but must avoid live attenuated vaccines due to potential safety risks from immunosuppression.

General Vaccination Principles for BIMZELX Patients

• Complete all age-appropriate vaccinations as recommended by current immunization guidelines prior to initiating treatment with BIMZELX 1
• Live attenuated vaccines are contraindicated in patients receiving BIMZELX due to the immunosuppressive effects of this IL-17A and IL-17F inhibitor 2
• Inactivated vaccines can be safely administered during BIMZELX therapy, though immune response may be suboptimal 2
• Vaccination should ideally be completed at least 2 weeks before starting BIMZELX therapy when possible 2

Specific Vaccine Recommendations

Recommended Vaccines (Inactivated/Non-Live)

• Influenza vaccine (inactivated): Yearly vaccination is recommended 2
• Pneumococcal vaccine: Recommended for all patients on BIMZELX 2
  • For pneumococcal vaccination, follow the standard schedule with PCV13/PCV15/PCV20 followed by PPSV23 as appropriate for age and risk factors 2
• COVID-19 vaccination: Follow current CDC guidelines for COVID-19 vaccination 2
• Recombinant zoster vaccine (Shingrix): Recommended for patients ≥50 years or ≥18 years at increased risk for zoster disease 2

Contraindicated Vaccines (Live)

• Measles, mumps, rubella (MMR) 2
• Varicella vaccine 2
• Live zoster vaccine (Zostavax) 2
• Other live vaccines: Yellow fever, oral typhoid, smallpox, BCG, live influenza (nasal spray) 2

Timing Considerations

• Administer all indicated vaccines at least 2 weeks before starting BIMZELX when possible 2
• If vaccination was not completed before therapy:
  • Inactivated vaccines can be administered during BIMZELX therapy 2
  • Live vaccines should be postponed until at least 3 months after discontinuation of BIMZELX 2
• For patients previously on other immunosuppressive therapies before switching to BIMZELX, follow appropriate waiting periods based on the previous medication before administering live vaccines 2

Special Considerations

• Close contacts and healthcare providers of patients on BIMZELX should receive all recommended vaccines, including seasonal vaccines, to reduce infection risk to the patient 2
• Travel vaccines: Prior to traveling to endemic areas of infection, patients should receive appropriate travel vaccinations (non-live only) and consult with an infectious disease specialist 2
• Post-transplant patients: Ensure post-stem cell transplant vaccinations have been carried out according to transplant vaccination schedules 2
• Monitoring: Consider assessment of antibody titers after vaccination in high-risk patients, as immune response may be suboptimal 2

Practical Approach to Vaccination in BIMZELX Patients

1. Review vaccination status at BIMZELX initiation
2. Administer all needed non-live vaccines as soon as possible
3. Avoid all live vaccines during treatment
4. Educate patients on the importance of having household contacts fully vaccinated
5. Consider antibody titer testing after vaccination in high-risk patients to confirm response

Remember that while BIMZELX is a newer biologic agent targeting IL-17A and IL-17F, the immunization principles follow general guidelines for patients on immunosuppressive biologics. The safety profile of BIMZELX includes increased risk of infections, making appropriate vaccination particularly important for these patients 3, 4.