Vaccine Access Frequently Asked Questions 

By Arthritis Foundation Staff

The Arthritis Foundation supports access to safe, evidence-based vaccines and recognizes the important role vaccines play in protecting the health of people living with arthritis.   

People with autoimmune forms of arthritis or other autoimmune diseases or chronic conditions, who may be at higher risk for serious infections, can safely receive most vaccines. However, individual circumstances vary. Some arthritis medications can affect which vaccines are recommended and when they should be given. We encourage patients and caregivers to talk with their rheumatologist, primary care provider, pediatrician or other healthcare professional to determine what is right for them. This resource provides practical information about vaccine timing and insurance coverage so you can have informed conversations with your healthcare team.  

Key Takeaways for Children & Teens with Arthritis  

• Vaccines are generally safe and important for children and teens with juvenile arthritis and other rheumatic diseases.  
• The Arthritis Foundation, along with 230 medical, public health, patient and community organizations supports the American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule.  
• Children with arthritis may need individualized vaccine recommendations based on their disease, immune status and medications.  
• Some arthritis medicines can affect:   
  • Which vaccines can be given  
  • When vaccines should be given  
  • How well vaccines work  
• Most non-live (inactivated or recombinant) vaccines can be given while receiving arthritis medications, but live vaccines require special planning.  
• Parents should work with both their pediatrician and pediatric rheumatology team when making vaccine decisions.  
• Never stop or delay an arthritis medication without guidance from the prescribing clinician.  
• If a child is behind on vaccinations, ask their healthcare team about a catch-up schedule.  
• Check vaccine requirements for school, childcare, camp, travel or other situations well in advance.  

Key Takeaways for Adults with Arthritis  

• Vaccines are generally safe and can help protect adults with arthritis from serious infections.  
• Community/family vaccination is important to help protect those who cannot be vaccinated or who have a weaker response to vaccines.  
• Some forms of arthritis and some arthritis medications can increase the risk of infection.  
• Adults should discuss vaccines with their rheumatologist and/or primary care provider.   
• Vaccine recommendations may vary based on:   
  • Age  
  • Arthritis diagnosis  
  • Other health conditions  
  • Current medications  
  • Pregnancy status  
  • Vaccination history  
  • Risk of exposure to infectious diseases  

1. Why do vaccines matter for people with arthritis?  

Some inflammatory and autoimmune forms of arthritis affect the immune system, which can make it harder to fend off infections. Medicines used to treat arthritis, including biologics and other immune-suppressing medicines, may also make it harder for the body to fight infections.  

These medicines can affect:  

• Which vaccines you can receive.   
• When you should get a vaccine.   
• How strongly your body responds.   
• Whether you may need another dose.   

Vaccination among family members and others in your community can also help protect people who cannot receive certain vaccines or may not get full protection because of their condition or treatment.  

Preventing infection may help you avoid missed school or work, disease flares and delays in arthritis treatment.  

The American College of Rheumatology provides vaccine guidance for people with rheumatic and musculoskeletal diseases, but you should get personalized guidance from your own healthcare team.   

2. Which vaccine schedule does the Arthritis Foundation support for children and teens?  

The Arthritis Foundation currently supports the American Academy of Pediatrics’ (AAP) recommended schedule for children and teens.  

The AAP schedule continues to recommend routine protection against 18 diseases. It is developed by experts in pediatrics, infectious diseases and public health using scientific and real-world evidence. Twelve national medical and healthcare organizations formally endorse the 2026 schedule.   

Families can review:  

• All About the AAP Recommended Immunization Schedule, written for parents and caregivers.   
• The full AAP Recommended Child and Adolescent Immunization Schedule, including clinical notes.   

Parents who have questions should talk with their child’s pediatrician. Families of children or teens with juvenile arthritis should also include their pediatric rheumatology care team.  

3. How should vaccines be timed around juvenile arthritis medicines?  

There is no single timing rule for every child with juvenile arthritis. The right plan depends on the vaccine, the medicine and the child’s health.  

Non-live vaccines  

Many non-live vaccines can be given during arthritis treatment. However, some arthritis medicines may reduce the body’s response to a vaccine or affect the best timing.  

Live vaccines  

Live vaccines use a weakened form of a virus. Examples include:  

• Measles, mumps and rubella (MMR)  
• Chickenpox (or varicella)  
• The combined MMR plus varicella (MMRV) vaccine  
• Rotavirus  
• Nasal-spray flu vaccine  

A vaccine may need to be given before arthritis treatment begins, or it may need to be delayed or timed around arthritis treatment, as directed by the child’s doctor.  

Ask your child’s care team:  

• Is this a live or non-live vaccine?   
• Can my child receive it while taking this medicine?   
• Should the vaccine or medicine be timed differently?   
• Does my child need another dose?   

Do not stop, delay or change methotrexate, biologic or other arthritis medicine for yourself or your child with arthritis without instructions from the prescribing clinician.   

Related Arthritis Foundation resource: Vaccines for Kids on Biologics.   

4. What should adults with arthritis know about vaccines?  

The Arthritis Foundation does not publish a separate adult vaccine schedule.  

Adults can use the current federal adult schedule as a general reference. They should also talk with their rheumatologist, primary care provider or other healthcare professional about vaccines based on their:  

• Age  
• Arthritis diagnosis  
• Other health conditions  
• Vaccine history  
• Medicines  
• Pregnancy or plans for pregnancy  
• Risk of infection or exposure  

Some arthritis medicines may affect which vaccines a person receives or how they are timed. The ACR also provides vaccine guidance for adults and children with rheumatic diseases.   

Adult resource: Current Adult Immunization Schedule.  

5. Who decides which vaccines are required for childcare or school?   

Your state usually decides which vaccines are required for school and childcare. Federal health agencies and medical groups make vaccine recommendations, but state laws set school entry requirements.   

These rules may differ by state, age, grade and type of school or program. A school or childcare provider may ask for records and apply the state’s rules.   

School requirements may not include every vaccine recommended by your child’s medical care team or the AAP. Check your state health department’s website and ask your school or childcare provider which records or forms you need.   

States also set their own rules for medical exemptions. A pediatrician or specialist should decide whether a vaccine is not medically appropriate for a particular child. Check your state health department’s current requirements and ask your school or childcare provider which records or forms you need if you need to request an exemption.  

6. Will insurance cover a recommended vaccine?  

Medical guidance and insurance coverage rules are not always the same.  

Federal rules require most private health plans to cover certain vaccines recommended by the Centers for Disease Control and Prevention without copays or other cost sharing when:  

• The recommendation applies to the patient.   
• The vaccine is received from a provider in the plan’s network.   
• Any required coverage period has begun.   

Before scheduling a vaccine, ask your health insurer:  

• Is the vaccine covered?   
• Will I owe a copay or other out-of-pocket costs?   
• Is the fee for giving the vaccine covered?   
• Does it require prior approval?   
• Is the provider or pharmacy in network?   
• Does my child qualify for the Vaccines for Children program, which provides free vaccines to those who are eligible?   

If coverage is denied:  

1. Ask for the reason in writing.   
2. Confirm that the provider is in-network.   
3. Ask whether the denial is for the vaccine, the fee to give it, or the location.   
4. Ask the healthcare provider to document why the vaccine is recommended.   
5. File an appeal with the health plan.   
6. Contact the Arthritis Foundation Helpline at 800-283-7800 for help understanding your options.   

7. Where can I find reliable information?  

For children and teens  

• Your child’s pediatrician and pediatric rheumatology care team  
• All About the AAP Recommended Immunization Schedule   
• AAP Recommended Child and Adolescent Immunization Schedule   
• AAP Vaccine Confidence Campaign   

For adults and arthritis-specific questions  

• Your rheumatologist or primary care provider  
• Current Adult Immunization Schedule   
• American College of Rheumatology vaccine guidance  

For access and school rules  

• Your state health department   
• Your state board of pharmacy   
• Your school nurse   
• Your health insurance plan   
• Arthritis Foundation Helpline: 800-283-7800   

Vaccine information can be confusing. Check who created the information and when it was updated. Talk with your healthcare team before changing a vaccine or medication plan.