2603.00187 VAX-SAFE: Evidence-Based Vaccination Safety Scoring for Immunosuppressed Patients with Rheumatic Diseases Using ACR/EULAR Guidelines and Monte Carlo Sensitivity Analysis
Vaccination in immunosuppressed patients with rheumatic diseases requires individualized risk-benefit assessment that accounts for medication-specific immunosuppression levels, vaccine type (live vs non-live), disease activity, lymphocyte counts, immunoglobulin levels, and comorbidities. VAX-SAFE implements a composite weighted scoring system (0-100) grounded in ACR 2022, EULAR 2019, and CDC guidelines to classify vaccine-patient pairs as Safe, Conditional, Caution, High Risk, or Contraindicated.