When first diagnosed with IBD, your doctor should take an immunisation history, and if any gaps are identified, you should be offered ‘catch up’ vaccinations.

If you are considering vaccinations for travel do talk this through with our IBD team. Sometimes a judgment needs to be made whether the risks of the disease you are being vaccinated against outweigh the risks from live vaccination.


CAN I HAVE IMMUNISATIONS WHILE ON BIOLOGICAL THERAPY?

It may be unsafe to be immunised with certain vaccinations while on Biological therapy.

You should not have any ‘live’ vaccines such as those for:

  • polio
  • yellow fever
  • rubella (German measles)
  • MMR (measles, mumps and rubella)
  • BCG (tuberculosis)

However, you may be able to have the inactivated polio vaccine. Flu jabs are currently safe as they are not live vaccines and the current recommendations are that everyone on Biological drugs should have an annual flu vaccination. However, the children’s nasal flu vaccine is live and should not be used.

If anyone in your family or household is due to have a live vaccine, check with your IBD team whether you need to take any special precautions. You should also check with your IBD team if you are in contact with a baby or young child undergoing a vaccination programme.


CAN I HAVE IMMUNISATIONS WHILE ON STEROIDS?

If you are taking steroids it is recommended that you avoid live vaccines, such as:

  • polio
  • yellow fever
  • BCG (tuberculosis)
  • rubella (German measles)
  • MMR (measles, mumps, and rubella)

As a rule you should avoid live vaccines from three weeks before starting steroids and then for three to six months after steroids have been discontinued. You should also avoid coming into contact with anyone who has recently received a live vaccine as there is a chance the infection could be passed to you.

Once on steroids you will still be able to take inactivated vaccines, such as hepatitis A, and, typhoid (but not the oral active typhoid vaccine). Guidelines recommend an annual flu vaccination (with the inactivated vaccine) for people with IBD regardless of whether or not you are taking immunosuppressant drugs.

It should be noted that the new nasal spray flu vaccine for children contains live forms of the flu virus and should not be used. Vaccines against pneumonia (such as Pneumovax®) should also be considered. If vaccinations are required for travel sometimes a judgment needs to be made with your IBD team about whether the risks of the disease (you are being vaccinated against) outweigh the risks from live vaccination. It is important not to have any vaccinations during or after steroid treatment without consulting your IBD team.

CAN I HAVE IMMUNISATIONS WHILE ON AZATHIOPRINE OR MERCAPTOPURINE?

If you are taking azathioprine or mercaptopurine you should not receive live vaccines, such as:

  • polio
  • yellow fever
  • BCG (tuberculosis)
  • rubella (German measles)
  • MMR (measles, mumps and rubella)

You should also avoid coming into contact with anyone who has recently received a live vaccine as there is a chance the infection could be passed to you.

You should wait at least three weeks from your last immunisation with a live vaccine before starting treatment with azathioprine or mercaptopurine, and you should not have live vaccines until three to six months after stopping treatment.

Once on thiopurine treatment you will still be able to take inactivated vaccines, such as hepatitis A, and typhoid. Guidelines recommend an annual flu vaccination (with the inactivated vaccine) for people with IBD regardless of whether or not you are taking immunosuppressant drugs. It should be noted that the new nasal spray flu vaccine for children contains live forms of the flu virus and should not be used. Vaccines against pneumonia (such as Pneumovax®) should also be considered.

It is important not to have any vaccinations during or within six months of stopping thiopurine treatment without consulting our IBD team.


References