Table 2 Vaccines and recommendations for their use in immune compromised inflammatory bowel disease patients*53
IllnessType of vaccineRecommendation in immune-compromised patients
Diphteria†Purified anatoxinRecommended
Tetanus†Purified anatoxinRecommended
Poliomyelitis†Oral route: live attenuatedContraindicated
Injectable: inactivatedRecommended
Pertussis‡Acellular antigenAuthorised
Hepatitis BRecombinant peptideRecommended
Pneumococcal disease23-valent purified capsular antigenRecommended
7-valent conjugated capsular antigenAuthorised (indicated for children only)
InfluenzaInactivated virusRecommended
Human papillomavirus infection§Recombinant L1 proteinAuthorised
Measles, mumps and rubellaLive attenuatedContraindicated
Chickenpox¶Live attenuatedContraindicated
Hepatitis A**Inactivated virusAuthorised
Yellow fever**Live attenuatedContraindicated
Cholera**Oral killedUse with caution
Oral liveContraindicated
Meningococcal disease**Conjugate polysaccharide CAuthorised
Polysaccharide combined A+CAuthorised
Polysaccharide combined A+C+W+YAuthorised
Typhoid**Vi capsular polysaccharideAuthorised
Rabies**Cell culture-derived vaccineAuthorised
Japanese encephalitis**Inactivated virusAuthorised
Tick-borne encephalitis**Inactivated virusUse with caution
Haemophilus influenzae B diseaseConjugated capsular polyosidique antigenAuthorised

  • *Immune-compromised patients are defined as: (1) treatment with glucocorticoids: prednisone ⩾20 mg/day equivalent for 2 weeks or more, and within 3 months of stopping; (2) treatment with methotrexate; (3) treatment with 6-mercaptopurine/azathioprine; treatment with infliximab or other tumour necrosis factor-blocking agent; (4) significant protein-caloric malnutrition.

  • †Adult patients with inflammatory bowel diseaseshould undergo combined vaccination against tetanus, diphtheria and poliomyelitis every 10 years.

  • ‡A booster dose could be administered at least once in adults, following each country’s recommendation on pertussis vaccination, in combination with vaccination against tetanus, poliomyelitis and diphtheria.54

  • §In young women with inflammatory bowel disease, human papilloma virus vaccination could be proposed; the same schedule as that recommended for the general population should be used.55

  • ¶Should be performed before starting treatment with immunosuppressive agents, the best time for immunisation being at diagnosis.

  • **To prevent travel-related illnesses.