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Prior to the visit:

Ensure patients receive a blood requisition form for the following blood tests: HAV IgG, HBVsAg, HBVsAb, HBV core IgG, HCV Ab, HIV Ab, Measles/mumps IgG, Varicella IgG

 

A general rule of thumb: 

Avoid Live vaccines! If a patient requires live vaccines, immunosuppressive medication should be held for 3 months before the vaccine and only resumed at minimum 3 weeks after the vaccine is given. Please contact the Gastroenterologist of the patient if a live vaccine is indicated for advice and close monitoring. 

 

Recommended vaccinations:

1.  Annual influenza

2.  Pneumococcal 

  • First dose of PCV13 to be given at either 8 weeks if on an immunosuppressive regimen, or after 1 year if immunocompetent

  • Second dose of PPSV23 to be given 5 years after initial dose

  • Third dose of PPSV23 to be given after 65 years of age

  • If the patient has been previously vaccinated with PPSV23, PCV13 should be administered at least 1 year after the last dose of PPSV23 in both patients with or without an immunosuppressive regimen
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3.  Shingrix

  • If patient has history of chickenpox or Varicella IgG positivity, vaccinate the patient at 50 years old

  • If patient has an unclear history of or has not had chickenpox but has Varicella IgG positivity, vaccinate the patient at 50 years old

  • If the patient has been vaccinated as a child and has Varicella IgG positivity, there is no need for the Shingrix vaccine
     

4.  COVID vaccines

  • It is generally recommended except in certain circumstances. Please see our other article on COVID vaccination in IBD patients for more information. 
     

5.  MMR (Mumps, Measles, Rubella)

  • If the patient’s IBD is stable, not requiring immunosuppressive medications, and the Measles/ Mumps IgG is negative, an MMR booster can be considered.
     

6.  HPV (Human Papilloma Virus) Vaccine 

  • This vaccine is recommended in all IBD patients aged 9-26 years in both genders
     

7.  Hepatitis B Vaccine

  • This vaccine is recommended in all pediatric IBD patients, and all unimmunized adult IBD patients with IBD
     

8. Hemophilus influenza B

  • Pediatric patients with IBD age 5 or younger are recommended to receive the vaccine
     

9. Tdap (Tetanus, Diphtheria, Pertussis) Vaccine

  • Both pediatric and adult patients with IBD are recommended to receive age-appropriate tetanus, diphtheria, and pertussis-containing vaccines

 

Reference for additional reading: 

  1. Benchimol EI, Tse F, Carroll MW, deBruyn JC, McNeil SA, Pham-Huy A et. al. Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD) - Part 1: Live vaccines. JCAG. 2021 Jul;4(4):e59-71. DOI: 10.1093/jcag/gwab015

  2. Jones JL, Tse F, Carroll MW, deBruyn JC, McNeil SA, Pham-Huy A et. al. Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD) - Part 2: Inactivated Vaccines. JAAG. 2021 Jul;4(4):e72-91. DOI: 10.1093/jcag/gwab016

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