If you suffer from inflammatory bowel disease (IBD), general health maintenance is an important part of staying healthy. Part of this includes getting vaccinated. We recommend you get vaccinated to avoid getting sick from infectious illnesses that are preventable.
In general, you will follow the same vaccination schedule as the rest of the population. An important exception to this is if you have a weak immune system from drugs like steroids at high doses, immunomodulators, and certain biologics that we use to treat IBD.
You, your gastroenterologist, and your general physician should work together to make sure you are properly vaccinated. Ideally, this should be when you are first diagnosed with the disease. It is important to note that you should not receive certain vaccines, called “live vaccines,” if your immune system is weak from medications we use to treat your IBD. Remember that there is no evidence to suggest that getting vaccinated will cause your IBD to become active.
Below is a list of medications often used to treat IBD, which can weaken your immune system to varying degrees:
- Steroids (i.e. prednisone) at dosages >20 mg daily for >2 weeks, or exposure to the drug within the previous 3 months at any dose
- Azathioprine (Imuran®, Azasan®) at dosages >3 mg/kg daily or exposure to the drug within the previous 3 months at this dose
- 6-mercaptopurine (6-MP, Purinethol®) >1.5 mg/kg day or exposure to the drug within the previous 3 months at this dose
- Methotrexate (MTX, Rheumatrex®, Mexate®) >0.4 mg/kg weekly (by mouth or by injection) or exposure to the drug within the previous 3 months at this dose
- Infliximab (Remicade®), adalimumab (Humira®), certolizumab (Cimzia®), golimumab (Simponi®), natalizumab (Tysabri®)
Vedolizumab (Entyvio®) vedolizumab is less associated with a weakened immune system but it is still advisable to receive vaccines... also need to add ustekinumab and tofa. This biologic, targeted specifically towards the immune system of the gastrointestinal tract , rather than the body as a whole, and as a result does not appear to weaken your immune system like the others listed above.