Vaccinations and immunosuppressive therapy

  I work in the field of child care.  I have exposure on occasion to blood and body fluids such as vomit, urine or bowel movements.  We do attempt to utilize universal precautions, but occasionally accidents happen too fast.  In addition, I have received a few rather severe human bites.  Because of these risks, our jobs have been classified high risk and we are entitled to free vaccination against Hepatitis B.
  I would like the immunizations...but have a question about whether or not it is wise to receive them while receiving immunosuppressive therapy...I am on prednisone now but possibly will soon be switched to Imuran or Methotrexate so that the prednisone can be tapered and discontinued.  The meds are for treatment of connective tissue disease.
  Under these conditions, are the vaccines considered safe and prudent?

[HFHSM.D.-D.M.]

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Dear Dee:
I appreciate your questions and I feel you bring up some excellent points regarding the hepatitis B vaccine.
First and foremost, the fact that you are on immunosuppressive medications will in no way affect the safety of the hepatitis B vaccine.  The vaccine is not a virus.  The vaccine is made from bio-engineered parts of the virus that should pose no health threat.  
The one problem is that immunosuppressive medication can affect the effectiveness of the vaccine.  We typically would recommend that you get the vaccines while you are on relatively low amounts of your medication.  However, I cannot state that one medication (imuran, prednisone, methotrexate) is less than immunosuppressive than another.  
You might want to go ahead and give the vaccines a try.  I would monitor whether you have had a good antibody response or not.  You may need a second series of injections.  However, there really should not be a down-side from trying.  
I hope this information is helpful to you. If you have additional questions or concerns, you can post them back to MedHelp of you can contact us directly at the Liver Clinic at Henry Ford at [phone].  
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.