Inflammatory Bowel Disease Center | Immunizations

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Back-to-school shots: Are live vaccines safe for children with inflammatory bowel disease taking immunosuppressive medication?

All children—from preschoolers to college students—should get vaccines to stay healthy. Many schools and daycares require students to get vaccinated against certain diseases (like measles) and recommend vaccination against more common viruses (like the flu) before the school year starts. 

But for children who require immunosuppressive medication to treat their inflammatory bowel disease (IBD), knowing which vaccines to get and which to avoid isn't always clear.

"It's important for all children to stay up to date on their immunizations, and children with IBD are no exception to that rule," says Tracee Saslowsky, a Pediatric Nurse Practitioner, with Boston Children's Hospital's Division of Gastroenterology, Hepatology and Nutrition. "But the caveat being that patients who take immunosuppressive medications to treat their IBD should avoid live vaccines."

Live vaccines, including the varicella vaccine and the nasal flu vaccine, contain an attenuated virus (or a weakened version of the virus) that helps the body learn how to fight against it. But if a person's immune system is compromised by immunosuppressive medicine, live vaccines can cause infections. For this reason, live vaccines should not be given to anyone taking immunosuppressive drugs or within one month after these drugs are stopped. The inactivated form of the vaccination should be used instead, whenever possible.

Fortunately, there are plenty of inactivated vaccines available, especially for seasonal vaccines like flu shots, which Saslowsky says are perfectly safe for people on immunosuppressant medication.

"We encourage all patients to get the flu vaccination every year, because it's proven to be effective," she says. "The flu can be a very difficult illness for children, especially those already dealing with gastrointestinal issues. The flu shot is your best bet to help you stay healthy, just as long as you are getting the appropriate type of shot, which in the case of patients on immunosuppressants is the inactive vaccine only."

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