Vaccine-Preventable Disease in IBD: Relevance, Guidelines, and Considerations for Implementation

Felix Zhou; Kyle Kilby; Jennifer Jones

doi:10.58931/cibdt.2023.1215

Authors

Felix Zhou, MD
Kyle Kilby, MD
Jennifer Jones, MD, MSc, FRCPC

DOI:

https://doi.org/10.58931/cibdt.2023.1215

Abstract

The increasing prevalence of vaccine-preventable diseases (VPDs) in patients with inflammatory bowel disease (IBD) has given rise to increased awareness of the need to educate clinicians and patients about the critical role of immunization in this patient population. In 2023, it was estimated that in the Canadian population, 320,000 individuals (0.83%) were affected by IBD. Patients with IBD are at risk of vaccine-preventable diseases as the result of several factors, including potentially reduced efficacy and safety of vaccinations in the context of systemic immunosuppressive therapies administered for the management of IBD2 and a state of malnutrition caused by the disease.

Barriers to the administration of vaccinations include: Clinicians’ reluctance to immunize patients with IBD; patient lack of awareness regarding the critical importance of a structured vaccination protocol; gastroenterologists’ assumption that immunization falls under the auspices of the primary care provider (PCP); and limited time and resources.

The objective of this paper is to highlight the need for broader implementation of the 2021 Canadian Association of Gastroenterology (CAG) Guidelines concerning both live and inactivated vaccines in patients with IBD. This overview focuses on commonly encountered VPDs for which administration of live and non-live vaccines may be required and for which an IBD-specific deviation from the NACI recommendations have been made. The vaccines selected for this brief overview are also commonly administered in clinical practice. Clinicians may experience uncertainty in relation to management of these vaccinations in practice.

Author Biographies

Felix Zhou, MD

Dr. Felix Zhou is a fourth-year gastroenterology resident at Dalhousie University. He obtained his honors degree in biology at the University of New Brunswick in Fredericton, New Brunswick. He completed his medical school training at Memorial University in 2019 and his internal medicine residency at Dalhousie University in 2022. Following his gastroenterology training he hopes to obtain further subspecialty training in inflammatory bowel disease in 2024.

Kyle Kilby, MD

Dr. Kyle Kilby is a second-year internal medicine resident at the University of Calgary. He completed a combined honours degree in biology, immunology, and microbiology at Dalhousie University in Halifax, Nova Scotia. He continued his studies at Dalhousie, graduating with his medical degree in 2021. Through medical school and his internal medicine residency, he has partnered with community groups to advocate for equity in healthcare and harm reduction. His research and clinical interests lie in health promotion and prevention of disease, as well as the role of robust social programming in improving the health of our communities.

Jennifer Jones, MD, MSc, FRCPC

Dr. Jennifer Jones obtained her MD and completed her internal medicine and gastroenterology fellowship training at Dalhousie University in Halifax, Nova Scotia. She then completed an advanced fellowship in Inflammatory Bowel Diseases at the Mayo Clinic in Rochester, Minnesota, USA. Following this she obtained her MSc in epidemiology while working at the IBD Clinic at the Foothills Medical Center in Calgary, Alberta. After this she worked as an assistant professor of medicine at the University of Saskatchewan in Saskatoon where she established the Multidisciplinary Inflammatory Bowel Diseases Program. Dr. Jones moved back to her home province of Nova Scotia where she serves as the medical lead of the Nova Scotia Collaborative Inflammatory Bowel Diseases program. She is currently as Associate Professor of medicine within the Division of Digestive Care and Endoscopy within the Department of Medicine (DoM) and is Chair of the DoM Clinical Systems and Innovation Committee. She recently completed Implementation Science Certification training through the University of California, San Francisco (UCSF) and her research interests include implementation and evaluation of innovative models of healthcare delivery, patient oriented IBD research, and IBD outcomes research.

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Vaccine-Preventable Disease in IBD

Relevance, Guidelines, and Considerations for Implementation

Authors

DOI:

Abstract

Author Biographies

Felix Zhou, MD

Kyle Kilby, MD

Jennifer Jones, MD, MSc, FRCPC

References

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