Vaccines and IBD

Why Do Kids With IBD Need Vaccines?

All kids should be protected from the diseases that vaccines can help prevent. But kids with inflammatory bowel disease (IBD) have a greater chance of getting infections, and infections can lead to flare-ups of IBD. So, it's especially important for them to get all their vaccines on time.

Kids with IBD should get their vaccines on the same schedule as other kids, with just a few differences if they take certain medicines.

What Vaccines Need Special Consideration?

Chickenpox, MMR (measles, mumps, and rubella), and intranasal flu vaccines contain weakened (or attenuated) live viruses. Such vaccines sometimes can cause a mild form of the disease they're meant to prevent. Usually, though, it's so mild that it isn’t a problem in healthy children. But these vaccines can cause a more severe disease in kids with weak immune systems. So live virus vaccines usually aren’t given to kids who take medicines that weaken their immune system (immunosuppressants), such as biologics or corticosteroids.

Fortunately, most kids with IBD already got these vaccines before they were diagnosed with the condition. If they haven’t, they can get them before they start taking immunosuppressants or after they stop. The exact timing may differ for different medicines. The health care team will go over your child’s vaccine records to figure out which vaccines your child needs and when they can get them.

People in the same household as a child who takes immunosuppressants can get most live virus vaccines. But the child shouldn't change the diapers of a baby who got the live rotavirus vaccine for a few weeks, and should keep away from anyone who had a rash after getting the live varicella vaccine.

What Vaccines Are Safe for Kids With IBD?

Kids with IBD should get the vaccines that do not contain live viruses as recommended. The vaccines don't contain any live viruses, so even kids on medicine that weakens the immune system can get them. The doctor might choose to give any needed vaccines before a child starts immunosuppressant medicine, though, just to make sure their body can respond as well as possible.

Vaccines that kids with IBD might need (either because they have not had them before or because they need more doses) include those that protect against:

• diphtheria, tetanus & pertussis
• influenza (flu) shot (not the nasal spray)
• hepatitis B
• hepatitis A
• meningococcus
• human papillomavirus (HPV)
• pneumococcus
• COVID-19
• polio (the inactivated shot)
• Haemophilus influenzae type b

The vaccines are safe to give to kids and teens with IBD and won't make their IBD symptoms worse.

What Else Should I Know?

Your child's doctor might order blood tests to check for antibodies to some types of viruses, such as measles, varicella, and hepatitis B. Antibodies are proteins in the blood that show if someone is protected from a virus, either because they got the vaccine or already had the infection. If antibody levels to a virus are low, the doctor may give your child the vaccine that protects against it, even if your child got the vaccine in the past.