Hold Off on JAK Inhibitors in Rheumatoid Arthritis Until After Shingles Vax?

— Good things come to those who wait -- and to those who don't wait

July 24, 2026

• 2 min read

Research has shown that the use of JAK inhibitors can weaken rheumatoid arthritis patients' responses to shingles vaccination.In a study from Japan, patients with rheumatoid arthritis who started tofacitinib after they received the first dose of a two-dose shingles vaccine had similar antibody levels by 12 weeks to those who waited until after the second dose.While patients in the first group had an earlier improvement in their arthritis compared with the second group, Clinical Disease Activity Index scores were similar by week 12.

Patients with rheumatoid arthritis who started a JAK inhibitor after they received one dose of a two-dose shingles vaccine series had similar varicella zoster virus (VZV) antibody levels by 12 weeks to those who waited until after the second dose, an exploratory randomized trial from Japan showed.