Vaccination in Patients with Inflammatory Bowel Diseases

Manser, Christine N.; Maillard, Michel H.; Rogler, Gerhard; Schreiner, Philipp; Rieder, Florian; Bühler, Silja

doi:10.1159/000503253

Cited by 35 publications

(42 citation statements)

References 77 publications

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“…For this reason, live attenuated vaccines are generally recommended for patients on low-dose (prednisone equivalent < 20 mg/day for < 14 days, methotrexate < 0.4 mg/kg/week, azathioprine < 3.0 mg/kg/day, or 6-mercaptopurine < 1.5 mg/kg/day) but not high-dose immunosuppression [ 47 ]. The package insert for vedolizumab states that patients on this biologic agent may receive live vaccines if the benefits outweigh the risks, whereas patients treated with ustekinumab and tofacitinib should not receive live vaccines because of the lack of supporting evidence [ 104 , 105 ]. Patients with IBD are at a significantly increased risk of developing herpes zoster infections, which can occur at an early age as compared to the general population [ 106 ].…”

Section: Immunisation In Patients With Altered Immunitymentioning

confidence: 99%

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

Righi

Gallo²,

Azzini

et al. 2021

Infect Dis Ther

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Vaccine-preventable diseases and their related complications are associated with increased morbidity and mortality in patients with altered immunocompetence. Optimised immunisation in this patient population is challenging because of limited data from vaccine trials, suboptimal vaccine efficacy and safety concerns. Reliable efficacy data are lacking among patients with altered immunocompetence, and existing recommendations are mainly based on expert consensus and may vary geographically. Inactivated vaccines can be generally used without risks in this group, but their efficacy may be reduced, and immunisation schedules vary according to local guidelines, age, and type and stage of the underlying disease. Live vaccines, if indicated, should be administered with care because of the risk of vaccine-associated disease. We have reviewed the current evidence on vaccination principles and recommendations in adult patients with secondary immunodeficiencies, including asplenia, HIV infection, stem cell and solid organ transplant, haematological malignancies, inflammatory bowel disease and other chronic disorders. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00404-y.

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Section: Immunisation In Patients With Altered Immunitymentioning

confidence: 99%

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

Righi

Gallo²,

Azzini

et al. 2021

Infect Dis Ther

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“…Many of these diseases are easily preventable by vaccination. A detailed summary of the main vaccines recommended in IBD patients according to international guidelines is reported in Table 1 [ 6 , 7 , 8 , 9 ]. In IBD patients not treated with immunosuppressants, there are no particular contraindications for the use of inactivated or live vaccines.…”

Section: Ibd and Vaccinesmentioning

confidence: 99%

“…Conversely, in immunosuppressed patients the differentiation between live vaccines and inactivated vaccines is crucial. For live vaccines (measles, mumps, and rubella, varicella, Herpes Zoster, yellow fever) the class of immunosuppressive drug, their dosage, and the timing after their suspension can play a role in the administration strategies [ 9 ]. On the other side, inactivated vaccines can be managed differently.…”

Section: Ibd and Vaccinesmentioning

confidence: 99%

How to Face the Advent of SARS-CoV-2 Vaccination in IBD Patients: Another Task for Gastroenterologists

et al. 2021

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The severity of the COVID-19 pandemic has led to an unprecedented effort to develop vaccines against SARS-CoV-2 infection since this seems to be the most effective strategy to counter the pandemic. In the past weeks, the administration of vaccines has started in different parts of the world sustaining the hype of significantly containing the impact of SARS-CoV-2 infection. However, the rapid time lapse from vaccine development to distribution has raised several concerns on its safety and efficacy. This topic is particularly felt by patients with chronic conditions and immumodulating therapies that could compromise their immune system such as inflammatory bowel disease (IBD). Here, we explore the potential future implications of the SARS-CoV-2 vaccines introduction in the IBD field, touching upon the clinical experience coming from available data on vaccinations against other infections. We also dissect the factors associated with the acceptability of SARS-CoV-2 vaccination, describing the possible strategies that gastroenterologist should adopt to reach the highest rate of vaccinations in IBD patients.

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“…Internists and obstetricians/gynecologists can appropriately address these conditions, whereas pediatricians cannot [9, 10]. On the other hand, adult gastroenterologists may not be familiar with vaccination issues or conditions associated with treatment using steroids, immunomodulatory agents, or biologics during periods of growth, and thus, the choice of treatments for childhood-onset IBD may be different from that of adults [11]. In addition, guardians often have a high level of trust in their pediatricians, not only for medical care but also for advices regarding social problems.…”

Section: Current Issues Related To Transitional Carementioning

confidence: 99%

Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

2020

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Background: Transition-related healthcare intervention has recently been receiving worldwide attention. Given the increasing incidence of pediatric inflammatory bowel disease (IBD) and its lifelong impact, transitional care has become an important issue. In Japan, guidelines to support the autonomy of IBD patients during transition were recently published. Summary: Here, we review current issues regarding care for IBD patients during transition from the pediatric to adult period in order to identify the barriers and key elements for successful transition in the context of the Japanese system. Although no single optimal model of transitional care exists, crucial elements identified so far include a joint pediatric/adult clinic or alternating visits between pediatric and adult healthcare providers, a multidisciplinary approach, and good coordination among stakeholders. Self-reliance and independence of patients with childhood-onset IBD are also considered essential for successful transition. Various tools for assessment of transition readiness have been validated and are considered useful. Better outcomes are expected for individually tailored transition, including improvements in medication adherence, perceived health status, quality of life, and self-management. The timing of transfer from a pediatric to an adult gastroenterologist should not be fixed because the issue is not chronological age but rather the degree of individual maturity. We also propose a standardized medical summary with a checklist template for official referral of patients from a pediatric to an adult gastroenterologist. Key Messages: Transition programs require a multidisciplinary approach with a coordinator (IBD nurse) and optimal collaboration and communication. Lack of resources and funding are also pertinent issues.

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Vaccination in Patients with Inflammatory Bowel Diseases

Abstract: e-g on behalf of the Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology

Cited by 35 publications

References 77 publications

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency

How to Face the Advent of SARS-CoV-2 Vaccination in IBD Patients: Another Task for Gastroenterologists

Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

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