I have IBD (Inflammatory Bowel Disease) – which vaccinations do I need to get?

If you have Crohn’s or Ulcerative Colitis you are at increased risk for vaccine preventable diseases. If you are also on immunosuppressive medications (high dose steroids, azathioprine or 6-MP, biologics, tofacitinib), your risk is even higher.

Click this image to see which vaccinations the Crohn’s and Colitis Foundation of America (CCFA) recommends for people with IBD.

IBD patients often do not get the vaccinations they need

Research presented at the Crohn’s & Colitis Congress, Jan. 18-20, 2018 in Las Vegas, however shows that there is confusion about who should provide this vaccinations, gastroenterologists or primary care providers. The result is that people with IBD get fewer vaccinations than the general population.

Why are primary care physicians reluctant to vaccinate people with IBD?

Primary care providers feel generally uncomfortable with patients with IBD. They may be particularly concerned when they contemplate using live vaccines: herpes zoster, varicella zoster, and MMR (measles, mumps, and rubella). Generally, it is best to use these vaccines only if patients have not been on immunosuppressive therapy within the previous 3 months and there are no plans to start immunosuppressive therapy within the next 6 weeks.

Why are gastroenterologists reluctant to vaccinate people with IBD?

While GI doctors tend to prescribe specialty specific vaccinations (Hepatitis A, Hepatitis B), they may not be up-to-date on the current general vaccination recommendations and assume that primary care will take care of it (but see above). Immunization schedules can be looked up here on the CDC website.

Who is going to vaccinate me?

The next time you see your Inflammatory Bowel Disease Specialist bring up the topic of vaccination.  You could print out a copy of the Cornerstone one-page handout “IBD Checklist for Monitoring & Prevention” which has a list of vaccine preventable illnesses. The Crohn’s and Colitis Foundation (CCFA) has a one-page-vaccination schedule, which is also reproduced in this blog. Identify who will take care of the missing vaccinations.

If you think that your IBD could be under better control, consider making an appointment with Dr. Klaus Gottlieb in San Luis Obispo or Templeton, CA.

 

References:
Hammami, Muhammad B. et al. P202 Vaccinations in IBD patients: gastroenterologists’ vs. Internists’ practice and perceptions of responsibility. Gastroenterology, Volume 154, Issue 1 (2018), S113 – S114
Farraye FA. Vaccination of Patients With Inflammatory Bowel Disease. Gastroenterology & Hepatology. 2017 Jul;13(7):431.

 

 

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