Infection Prevention While on Biologic Medications
Practical steps to protect yourself while on immunosuppressive therapy
Key Takeaways
- Biologics increase the risk of certain infections — but serious infections are uncommon in most patients
- Vaccination before starting biologic therapy provides the best immune protection
- Hand hygiene remains the single most effective infection prevention measure
- Know the warning signs of serious infection — fever >100.4°F, chills, persistent cough, wounds that won't heal
- Tell your prescriber about any infection or fever promptly — do not wait
Your Infection Risk on Biologics
Biologic medications selectively suppress specific inflammatory pathways, which can reduce your ability to fight certain types of infections. The degree of immunosuppression varies by drug class — JAK inhibitors and TNF inhibitors carry the highest infection risk; gut-selective agents like Entyvio and targeted agents like Dupixent have lower systemic infection risk profiles.
Understanding your risk and taking preventive steps significantly reduces the likelihood of serious infections. The vast majority of patients on biologic therapy do not experience serious infections.
Infection Prevention Checklist
🧼 Hand Hygiene
Wash hands frequently with soap and water for at least 20 seconds, especially before eating, after using the restroom, and after contact with sick individuals. Use alcohol-based hand sanitizer when soap and water are unavailable.
💉 Vaccinations
Complete all recommended vaccinations before starting your biologic. Annual flu shot (inactivated), Shingrix (especially on JAK inhibitors or TNF inhibitors), pneumococcal vaccines, and COVID-19 vaccines are all recommended. See our vaccine guide.
🏥 Dental and Medical Care
Maintain regular dental visits — oral infections can spread. Inform all healthcare providers (dentists, surgeons, urgent care) that you are on a biologic before any procedure.
👥 Sick Contact Avoidance
Avoid close contact with people who are visibly ill. During respiratory illness seasons, consider masking in crowded indoor settings. Inform household members about your immunosuppressed status so they prioritize their own vaccination.
🐾 Animal and Environmental
Wear gloves when gardening (soil contains fungal spores). Avoid handling animal waste without gloves. Avoid bird droppings (histoplasmosis risk). Follow food safety guidelines carefully — proper cooking temperatures, avoid raw meat, fish, and unpasteurized dairy.
✈️ Travel Precautions
Before international travel, check destination-specific infection risks and required vaccinations with your travel medicine provider and prescribing specialist. Some travel vaccines are live and contraindicated on biologics. See our travel guide.
Warning Signs: When to Call Your Doctor Immediately
🚨 Seek immediate medical attention if you have:
- Fever greater than 100.4°F (38°C)
- Chills, sweating, or shaking
- Persistent cough, shortness of breath, or chest pain
- Painful, red, swollen wounds or skin that is warm to touch and spreading
- Painful urination or frequent urination with fever
- Severe abdominal pain with fever
- Stiff neck or severe headache with fever
- Unusual fatigue combined with any of the above
Should You Hold Your Biologic During an Infection?
For minor infections (mild cold, minor skin infection responding to antibiotics), you generally do not need to stop your biologic — but inform your prescriber. For serious infections (hospitalization-level bacterial infections, active TB, invasive fungal infection), your prescriber will typically advise holding your biologic until the infection is fully treated and resolved. Never stop your biologic without medical guidance.
💬 BiologicHealthPlus Clinical Pharmacists Available 24/7
If you develop signs of infection and are unsure whether to hold your biologic, call us immediately. Our pharmacists will advise you and coordinate with your prescriber.
📚 Sources & Further Reading
Content developed with reference to leading health organizations, peer-reviewed research, and FDA prescribing information.
Medical Disclaimer: Educational content reviewed by the BiologicHealthPlus Clinical Team. Consult your healthcare provider for personalized advice. Last reviewed: August 2026.