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Table 4 Minimal period recommended between therapy withdrawal and yellow fever vaccination in patients with CIMID

From: Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases

Drug Interval between withdrawal and YFV
Prednisone > 20 mg/day or pulse methylprednisolone At least one month
Hydroxychloroquine, sulfasalazine, acitretin, methotrexate ≤20 mg/week, or leflunomide 20 mg/daya Consider vaccination without interval
Methotrexate > 20 mg/week At least 1 month
Azathioprine, mycophenolate mofetil or sodic, cyclosporine, tacrolimus, or cyclophosphamide At least 3 months
Tofacitinib At least 2 weeks
Anti-cytokines and co-stimulation inhibitor 4–5 half-livesb
B-lymphocyte depletors 6–12 months
  1. the medical criterion to carry out the drug elimination protocol before indicating the vaccine bbased on pharmacological half-life, except for B-lymphocyte depletors