Drug Interaction Report

Anakinra and Smallpox Monkeypox Vaccine: Interaction Details

Name: Anakinra and Smallpox Monkeypox Vaccine Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Anakinra and Smallpox Monkeypox Vaccine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Anakinra

Kineret Kineret®

Smallpox Monkeypox Vaccine

No brand names on record

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Jul 11, 2026

Editorial policy · Data sources

Interaction severity

Moderate

Can be significant — usually manageable with monitoring.

Minor

Moderate

Major

Contraindicated

How we grade severity & evidence

Severity levels

Contraindicated: These should generally not be used together.
Major: Potentially serious — often needs a change or close monitoring.
Moderate: Can be significant — usually manageable with monitoring.
Minor: Usually limited clinical impact.

Evidence grades

Established: Well documented — supported by controlled studies or strong clinical data.
Probable: Good supporting evidence, though not definitively proven.
Suspected: Some evidence suggests this interaction, but it is not well established.
Possible: Limited or conflicting evidence; the interaction may occur.
Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 29 documented Anakinra interactions, 15 are rated moderate — including this one.

Onset

unspecified

Evidence

theoretical

Severity

Moderate

What happens

An increased risk of secondary transmission of infection by the live vaccine

Interaction Deep Dive

Although no data are available regarding the effects of vaccination, including secondary transmission of infection from live vaccines, vaccination with live vaccines is not recommended in patients receiving anakinra therapy¹. Based on its mechanism of action, the possibility exists for anakinra to affect host defenses against infections since the cellular immune response may be altered.

Why it happens (mechanism)

Altered cellular immune response

Common questions

Can I take Anakinra and Smallpox Monkeypox Vaccine together?

An increased risk of secondary transmission of infection by the live vaccine Always confirm with your pharmacist or prescriber before making any change.

How serious is the Anakinra and Smallpox Monkeypox Vaccine interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

Does my dose of Anakinra or Smallpox Monkeypox Vaccine need adjusting while I take them together?
What symptoms should prompt me to call you or my prescriber right away?
Does the timing of my doses matter for this combination?
Is there anything you'd monitor while I'm on both?

References (1)

Product Information: KINERET(R) subcutaneous injection, anakinra subcutaneous injection. Amgen,Inc, Thousand Oaks, CA, 2006. DailyMed

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HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

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