Vaccination strategies in patients with IBD

Nat Rev Gastroenterol Hepatol. 2013 May;10(5):277-85. doi: 10.1038/nrgastro.2013.28. Epub 2013 Feb 19.

Abstract

Patients with IBD are at increased risk of infection, in part owing to the disease itself, but mostly because of treatment with immunosuppressive drugs. Although many of these infections are vaccine-preventable, vaccination coverage in patients with IBD is extremely low. The vaccine strategies examined in this Review are based on data that enable us to provide practical advice for clinicians. Clinical evidence indicates that vaccines do not increase the risk of relapse in patients with IBD. Live vaccines are contraindicated in immunocompromised individuals, but inactivated vaccines can be safely administered. Most patients receiving immunosuppressive therapy develop an immune response after vaccination, but response rates might differ from those of nonimmunosuppressed individuals. Therefore, vaccination status should be checked and updated upon diagnosis of IBD.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunization Schedule
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Infections / etiology*
  • Infections / immunology
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Practice Guidelines as Topic*
  • Vaccination / methods*
  • Vaccines / administration & dosage*

Substances

  • Immunosuppressive Agents
  • Vaccines