Table 2.
Vaccine Recommendations for Inflammatory Bowel Disease Patients Receiving Thiopurines
| Vaccine | Route | Number of doses | Comments |
|---|---|---|---|
| Hepatitis B | Intramuscular | 3 doses (0, 1, 6 months) | Checking anti-HBs titer 1 month after the last dose may be useful |
| Influenza | Intramuscular | 1 dose annually | Do not use live nasal vaccine |
| Pneumococcus | Intramuscular | 1 or 2 doses | One time revaccination after 65 years of age (at least 5 years after last vaccination) |
| Diphtheria, tetanus | Intramuscular | 1 dose every 10 years | First dose may be Tdap (Tetanus, diphtheria, acellular pertussis) instead of Td in patients < 65 years old |
| Hepatitis A | Intramuscular | 2 doses 6–12 months apart | A combination of hepatitis A and B vaccine is also available (dose at 0, 1 and 6 months) |
| Varicella | Intramuscular | 2 doses 4–6 weeks apart | Shingles (live vaccine) vaccine is distinct and more potent compared to varicella vaccine and a single dose of vaccine administered subcutaneously is recommended in patients > 60 years of age |
| Measles, mumps, rubella | Intramuscular | 2 doses 4 weeks apart | Contraindicated during thiopurine therapy |
anti-HBs, hepatitis B surface antibody.