Should My Patient with Inflammatory Bowel Disease on Immunosuppressive Therapy be Vaccinated against Influenza Virus?

Abstract

Crohn's disease and ulcerative colitis are variants of inflammatory bowel disease (IBD) for which immunosuppressive therapy is often required. Immunosuppressed patients are at increased risk for infections, including vaccine-preventable diseases such as influenza. Although several guidelines recommend routine influenza immunization for such patients, recent literature suggests that this patient population may be inadequately immunized. Current research suggests that inactivated influenza vaccines are effective, well tolerated and can be administered safely in most IBD patients. Studies in other immunosuppressed populations have also demonstrated the safety of inactivated vaccines. The present article reviews the literature regarding the safety and efficacy of influenza vaccination in IBD patients receiving immunosuppressive therapy.

SARS-CoV-2 vaccination does not induce relapses of patients with inflammatory bowel disease

“…In contrast, patients with IBD did not suffer from an increased frequency of IBD flares after SARS-CoV-2 vaccination. Recent studies also proved the safety of other vaccines, such as the influenza vaccine, in patients with IBD [13,14]. A recent umbrella review of meta-analyses showed that vaccinations are not associated with an increased risk of IBD [15].…”

Improving immunization strategies in patients with inflammatory bowel disease

“…Because immunomodulators are used to treat IBD patients, these patients are susceptible to infection, with a high rate of morbidity and mortality [92,93]. Therefore, this group of patients should be immunized prophylactically against these infections [94], preferably upon initial presentation and once the start of immunosuppressive agents is planned [95]. Given the increased risk of vaccine-related infections, live vaccines should be avoided in immunocompromised patients.…”

Vaccination of patients with inflammatory bowel disease: Practical recommendations

“…The safety of influenza vaccines in patients with immune-mediated diseases is similar to the general population. Studies in these patients show no relationship between clinical activity and vaccination (18,39). Immune response to vaccination may be diminished in patients with IBD on immunosuppressants or immunomodulators: Mamula et al analyzed response rates in children with IBD and observed seroconversion in 33 to 85 % of vaccine recipients, with response percentage being lower in those on combined therapy with immunomodulators and infliximab (40).…”