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Update on Vaccinating the Patient With Inflammatory Bowel Disease

Current Treatment Options in Gastroenterology volume 16, pages 548–560 (2018)Cite this article

Abstract

Purpose of review

Patients with inflammatory bowel disease (IBD) are at increased risk of infectious diseases independent of their immunosuppression status, and yet, studies suggest that this population is not receiving standard vaccinations at the same rate as the general population. This review seeks to understand why IBD patients may not be receiving recommended immunizations and to provide guidelines on vaccinating this vulnerable population.

Recent findings

Inactive vaccines are recommended for patients with IBD regardless of immunosuppression status due to the increased risk for many vaccine-preventable illnesses. Certain live vaccines can be administered to the immunocompromised patient with IBD. Additionally, many patients with IBD will be immunosuppressed some time in their disease course, further increasing their risk for infection. Despite this understanding, patients with IBD have poor vaccination rates. Inadequate knowledge, limited time with patients, and lack of consensus as to who is responsible for identifying and administering vaccinations are some of the most important barriers to vaccinating the patient with IBD.

Summary

In this review, we discuss guidelines for vaccinating both the immunocompetent and immunosuppressed patient with IBD as well as provide vaccine-specific recommendations. The evidence suggests that patients with IBD are not receiving recommended vaccinations because of misconceptions on the part of patients as well as a paucity of knowledge by their health care team. Educational programs can be successfully implemented to increase knowledge about appropriate vaccinations and can ultimately increase vaccine uptake among patients with IBD. In the end, gastroenterologists and primary care physicians must work together with their patients with IBD to ensure that recommended vaccinations are administered.

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Affiliations

  1. Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA, USA

    Jennifer Coukos MD

  2. Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA

    Francis A. Farraye MD, MSc

Authors
  1. Jennifer Coukos MD
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Correspondence to Francis A. Farraye MD, MSc.

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Conflict of Interest

Francis Farraye reports personal fees from Braintree Labs, Ferring, Janssen, and Merck and personal fees from Pfizer, Takeda, Lilly, Mesoblast, Protagonist, Theravance, and Innovation Pharmaceuticals, outside the submitted work. Jennifer Coukos declares no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

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Coukos, J., Farraye, F.A. Update on Vaccinating the Patient With Inflammatory Bowel Disease. Curr Treat Options Gastro 16, 548–560 (2018). https://doi.org/10.1007/s11938-018-0200-4

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  • DOI: https://doi.org/10.1007/s11938-018-0200-4

Keywords

  • Inflammatory bowel disease
  • Immunocompromised
  • Preventative health
  • Vaccination
  • PPSV23
  • PCV 13
  • Hepatitis A
  • Hepatitis B
  • Varicella
  • Zoster
  • HPV
  • Travel