He, too, pointed out the risks of long-term Immunosuppression- but said they have to be weighed against the benefits.
Generalised morphoea is usually not suitable for topical therapy, due to the large surface area involved,
so phototherapy or Immunosuppression is usually required.
As with other live virus vaccines, the nasal spray vaccine should not be given for any reason to pregnant women or people with immune suppression, including those with immune deficiency diseases, such as AIDS or cancer,
or people who are being treated with medications that cause Immunosuppression.