Table 3.

Summary of Consensus Recommendations for Immunizations in Patients With Inflammatory Bowel Disease

Principles of immunization of patients with IBD

Recommendation 1: In all patients with IBD, a complete review of the patient’s history of immunization and VPDs should be performed at diagnosis and updated at regular intervals by IBD care providers. Ungraded good practice statement.

Recommendation 2: In patients with IBD, all appropriate vaccinations should be given as soon as possible, and ideally prior to initiation of immunosuppressive therapy. Ungraded good practice statement.

Recommendation 3: In patients with IBD who require urgent immunosuppressive therapy, treatment should not be delayed in order to provide vaccinations. Ungraded good practice statement.

Live vaccines

MMR

Recommendation 4A: In MMR-susceptible pediatric patients with IBD not on immunosuppressive therapy, we recommend MMR vaccine be given. GRADE: Strong recommendation, moderate CoE Recommendation 4B: In MMR-susceptible pediatric patients with IBD on immunosuppressive therapy, we suggest against giving MMR vaccine. GRADE: Conditional recommendation, very low CoE

Recommendation 5A: In MMR-susceptible adult patients with IBD not on immunosuppressive therapy, we recommend MMR vaccine be given. GRADE: Strong recommendation, moderate CoE Recommendation 5B: In MMR-susceptible adult patients with IBD on immunosuppressive therapy, we suggest against giving MMR vaccine. GRADE: Conditional recommendation, very low CoE

Varicella

Recommendation 6A: In varicella-susceptible pediatric patients with IBD not on immunosuppressive therapy, we recommend varicella vaccine be given. GRADE: Strong recommendation, moderate CoE Recommendation 6B: In varicella-susceptible pediatric patients with IBD on immunosuppressive therapy, we suggest against giving varicella vaccine. GRADE: Conditional recommendation, very low CoE

Recommendation 7A: In varicella-susceptible adult patients with IBD not on immunosuppressive therapy, we suggest varicella vaccine be given. GRADE: Conditional recommendation, very low CoE Recommendation 7B: In varicella-susceptible adult patients with IBD on immunosuppressive therapy, we suggest against giving varicella vaccine. GRADE: Conditional recommendation, very low CoE

Statements with no recommendations

No Recommendation A: In infants born of mothers using biologic therapies, the consensus group could not make a recommendation for or against giving live vaccines in the first 6 months of life.

CoE, certainty of evidence; MMR, measles-mumps-rubella; VPDs, vaccine preventable diseases.