Being vaccinated against infections is a vital part of an overall healthcare plan for people who haveinflammatory bowel disease (IBD).Staying up-to-date on immunizations is important for many reasons, but especially when biologic medications might be used in the future.
In general, the most beneficial time to give vaccinations is before a biologic is started, but some might also be given when they are needed after that.
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People with IBD should check with their physicians about their vaccination status. Adults, in particular, may need a plan to get in all the recommended vaccinations they need. Being proactive about immunizations will be the best defense against preventable infections in the future.
In general, vaccinations are recommended before a patient starts on a biologic therapy. Immunization against common infections is necessary because biologic therapy suppresses the immune system.This means a person receiving a biologic drug may be more likely to get an infection.
Infections can cause a lot of harm and even mean the biologic has to be stopped for a time while the infection is resolved. That’s not an outcome that would be beneficial for treating the underlying IBD, and that’s why vaccinations are often given before starting a biologic drug, or even sometimes after.
Should Biologic Therapy Be Postponed for Vaccines?
A physician will be the best resource to answer this question, but in most cases, probably not. Many vaccinations could still be given after starting biologic therapy.
The type that is generally to be avoided is thelive attenuated vaccines, or LAVs, which are vaccines that contain a live, but weakened virus.
As soon as biologics are discussed as a treatment option, vaccines should be part of the conversation.
Vaccines Recommended for Those Receiving Biologic Therapy
Every patient’s vaccination plan will be different, based on the vaccinations they’ve already received and their risk of developing certain infections.
The physician administering the vaccines should work with the IBD patient to develop the plan that ensures full vaccination coverage. Some vaccinations are considered safe for those already undergoing treatment with biologics:
Vaccines Recommended In Certain Circumstances
Certain other vaccines may be given to adults with IBD who take biologics:
Live Vaccines Not Recommended While Receiving Biologic Therapy
People with IBD receiving biologic medications should not receive vaccinations that contain live viruses. Ideally, if these vaccines are needed, they should be given before starting therapy with a biologic:
Other live vaccines include the rotavirus, typhoid, and the flu (nasal spray) vaccines.
A Word From Verywell
Immunology is a complex science and it becomes even more so in people who have a chronic illness like IBD. While there are guidelines as to what vaccines are recommended in people with IBD who are receiving a biologic, there are also exceptions. It’s important for anyone with IBD to be up-to-date with vaccines, ideally before starting biologic therapy, because these drugs suppress the immune system.
However, many vaccines can still be given to a patient who is taking a biologic. The key to all of this is to have an open dialogue about vaccination with your healthcare professional before drugs that suppress the immune system are needed. Decisions about when to vaccinate and if to hold off on treatment until after vaccinating is an individual decision that should be made along with a gastroenterologist and/or an internist or family physician.
Correction - August 24, 2023: This article was updated to correct the recommendation for the herpes zoster vaccine, which is no longer a live vaccine.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Reich J, Wasan S, Farraye FA.Vaccinating patients with inflammatory bowel disease.Gastroenterol Hepatol (N Y). 12(9):540-546. PMID: 27917091Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 23(1):50-74. doi:10.1177/1203475418811335Johns Hopkins Arthritis Center.Side effects of biologic medication.Centers for Disease Control and Prevention.Hib vaccination: what everyone should know.Centers for Disease Control and Prevention.Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV.Dasharathy SS, May F, Myint A, et al.Pneumococcal vaccination recommendation and completion rates among inflammatory bowel disease patients within a large academic health system.Gastroenterology. 159(2):E28-E29. doi:10.1053/j.gastro.2020.06.069Crohn’s & Colitis Foundation.Fact sheet: influenza.Centers for Disease Control and Prevention.Recommended adult immunization schedules for ages 19 years or older, United States, 2021.American Gastroenterological Association.Inflammatory bowel disease (IBD): Vaccine recommendations.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Reich J, Wasan S, Farraye FA.Vaccinating patients with inflammatory bowel disease.Gastroenterol Hepatol (N Y). 12(9):540-546. PMID: 27917091Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 23(1):50-74. doi:10.1177/1203475418811335Johns Hopkins Arthritis Center.Side effects of biologic medication.Centers for Disease Control and Prevention.Hib vaccination: what everyone should know.Centers for Disease Control and Prevention.Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV.Dasharathy SS, May F, Myint A, et al.Pneumococcal vaccination recommendation and completion rates among inflammatory bowel disease patients within a large academic health system.Gastroenterology. 159(2):E28-E29. doi:10.1053/j.gastro.2020.06.069Crohn’s & Colitis Foundation.Fact sheet: influenza.Centers for Disease Control and Prevention.Recommended adult immunization schedules for ages 19 years or older, United States, 2021.American Gastroenterological Association.Inflammatory bowel disease (IBD): Vaccine recommendations.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Reich J, Wasan S, Farraye FA.Vaccinating patients with inflammatory bowel disease.Gastroenterol Hepatol (N Y). 12(9):540-546. PMID: 27917091Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 23(1):50-74. doi:10.1177/1203475418811335Johns Hopkins Arthritis Center.Side effects of biologic medication.Centers for Disease Control and Prevention.Hib vaccination: what everyone should know.Centers for Disease Control and Prevention.Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV.Dasharathy SS, May F, Myint A, et al.Pneumococcal vaccination recommendation and completion rates among inflammatory bowel disease patients within a large academic health system.Gastroenterology. 159(2):E28-E29. doi:10.1053/j.gastro.2020.06.069Crohn’s & Colitis Foundation.Fact sheet: influenza.Centers for Disease Control and Prevention.Recommended adult immunization schedules for ages 19 years or older, United States, 2021.American Gastroenterological Association.Inflammatory bowel disease (IBD): Vaccine recommendations.
Reich J, Wasan S, Farraye FA.Vaccinating patients with inflammatory bowel disease.Gastroenterol Hepatol (N Y). 12(9):540-546. PMID: 27917091
Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 23(1):50-74. doi:10.1177/1203475418811335
Johns Hopkins Arthritis Center.Side effects of biologic medication.
Centers for Disease Control and Prevention.Hib vaccination: what everyone should know.
Centers for Disease Control and Prevention.Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV.
Dasharathy SS, May F, Myint A, et al.Pneumococcal vaccination recommendation and completion rates among inflammatory bowel disease patients within a large academic health system.Gastroenterology. 159(2):E28-E29. doi:10.1053/j.gastro.2020.06.069
Crohn’s & Colitis Foundation.Fact sheet: influenza.
Centers for Disease Control and Prevention.Recommended adult immunization schedules for ages 19 years or older, United States, 2021.
American Gastroenterological Association.Inflammatory bowel disease (IBD): Vaccine recommendations.
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