Kathryn: Good recommendations. In fact, I recommend that all SLE pts get both pneumococcal vaccines (Prevnar and Pneumovax) even if they are only on hydroxychloroquine (HCQ) and are less than 50yo. A study from the Netherlands showed a higher rate for severe pneumococcal infections even in patients who were only on HCQ, and the authors recommended that all SLE patients receive pneumococcal vaccines. Reference = Luijten R, et al. Lupus. 2014 JUL;23(14):1512-1516.