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Vaccination Guide for
Immunosuppressed Patients with IBD
This tool is an overview of vaccinations being used in the care of patients with inflammatory bowel disease (IBD). It is designed for IBD nurses and health care providers to assist in educating patients and selecting appropriate vaccination options.
My patient is prescribed prednisone/prednisolone now or in the last 4 weeks:
(Steroids: Patients on ≥ 2 mg/kg/day (patients < 10 kg) or ≥ 20 mg/day (patients ≥ 10kg) for at least 2 weeks)
Yes No
My patient is prescribed either azathioprine or methotrexate now or within the next 4 weeks:
Yes No
My patient is prescribed biologic therapy (anti-TNF, anti IL12/23, Ant-integrin) or small molecules (JAK inhibitor):
Yes No
*If your patient is on monotherapy with only 5-ASA (i.e. Pentasa, Mezavant, Asacol, Octasa) OR sulfasalazine OR Cortiment MMX OR Entocort, they are not immunocompromised and can receive vaccines as per the routine schedule.
**Some IBD experts may have different thresholds for defining immune suppression. Ultimately the decision relies on the clinician’s clinical judgment. See: ACIP Altered Immunocompetence Guidelines for Immunizations | CDC and Immunization of immunocompromised persons: Canadian Immunization Guide – Canada.ca.
If your patient has been prescribed other immunomodulating (immunosuppressive) therapies, contact the prescriber if unsure about their safety for vaccine administration