Vaccine-preventable disease in IBD

Abstract

The increasing prevalence of vaccine-preventable diseases (VPDs) in patients with inflammatory bowel disease (IBD) has given rise to increased awareness of the need to educate clinicians and patients about the critical role of immunization in this patient population. In 2023, it was estimated that in the Canadian population, 320,000 individuals (0.83%) were affected by IBD. Patients with IBD are at risk of vaccine-preventable diseases as the result of several factors, including potentially reduced efficacy and safety of vaccinations in the context of systemic immunosuppressive therapies administered for the management of IBD2 and a state of malnutrition caused by the disease. Barriers to the administration of vaccinations include: Clinicians’ reluctance to immunize patients with IBD; patient lack of awareness regarding the critical importance of a structured vaccination protocol; gastroenterologists’ assumption that immunization falls under the auspices of the primary care provider (PCP); and limited time and resources. The objective of this paper is to highlight the need for broader implementation of the 2021 Canadian Association of Gastroenterology (CAG) Guidelines concerning both live and inactivated vaccines in patients with IBD. This overview focuses on commonly encountered VPDs for which administration of live and non-live vaccines may be required and for which an IBD-specific deviation from the NACI recommendations have been made. The vaccines selected for this brief overview are also commonly administered in clinical practice. Clinicians may experience uncertainty in relation to management of these vaccinations in practice.