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
​​
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:
-
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
-
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