Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Vaccination strategies in patients with IBD

Nature Reviews Gastroenterology & Hepatology volume 10, pages 277–285 (2013)Cite this article

Subjects

Abstract

Patients with IBD are at increased risk of infection, in part owing to the disease itself, but mostly because of treatment with immunosuppressive drugs. Although many of these infections are vaccine-preventable, vaccination coverage in patients with IBD is extremely low. The vaccine strategies examined in this Review are based on data that enable us to provide practical advice for clinicians. Clinical evidence indicates that vaccines do not increase the risk of relapse in patients with IBD. Live vaccines are contraindicated in immunocompromised individuals, but inactivated vaccines can be safely administered. Most patients receiving immunosuppressive therapy develop an immune response after vaccination, but response rates might differ from those of nonimmunosuppressed individuals. Therefore, vaccination status should be checked and updated upon diagnosis of IBD.

Key Points

  • Vaccines are underprescribed in patients with IBD; these patients are thus at risk of infections that might be easily avoided through a standardized vaccination program

  • The characteristics of IBD and the immunosuppressive agents prescribed to treat this disease could lead to reduced response rates to vaccinations

  • As most patients with IBD will receive immunosuppressants at some time during their life, immunization status should be checked upon diagnosis of the disease

  • If the patient lacks immunity, the vaccines should be administered as soon as possible to take advantage of the short time frame when they are not receiving immunosuppressive drugs

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Viget, N., Vernier-Massouille, G., Salmon-Ceron, D., Yazdanpanah, Y. & Colombel, J. F. Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis. Gut 57, 549–558 (2008).

    CAS  PubMed  Google Scholar 

  2. Rahier, J. F. et al. European evidence-based Consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J. Crohns Colitis 3, 47–91 (2009).

    CAS  PubMed  Google Scholar 

  3. Rahier, J. F. et al. Vaccinations in patients with immune-mediated inflammatory diseases. Rheumatology (Oxford) 49, 1815–1827 (2010).

    CAS  Google Scholar 

  4. Sands, B. E. et al. Guidelines for immunizations in patients with inflammatory bowel disease. Inflamm. Bowel Dis. 10, 677–692 (2004).

    PubMed  Google Scholar 

  5. Demicheli, V., Jefferson, T., Rivetti, A. & Price, D. Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD004407. http://dx.doi.org/10.1002/14651858.CD004407.pub2.

  6. Chalmers, A. et al. Immunization of patients with rheumatoid arthritis against influenza: a study of vaccine safety and immunogenicity. J. Rheumatol. 21, 1203–1206 (1994).

    CAS  PubMed  Google Scholar 

  7. Centers for Disease Control. Guide to Vaccine Contraindications and Precautions. CDC [online], (2009).

  8. Levin, M. J. Varicella vaccination of immunocompromised children. J. Infect. Dis. 197 (Suppl. 2), S200–S206 (2008).

    PubMed  Google Scholar 

  9. Lu, Y. & Bousvaros, A. Varicella vaccination in children with inflammatory bowel disease receiving immunosuppressive therapy. J. Pediatr. Gastroenterol. Nutr. 50, 562–565 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Coates, T., Wilson, R., Patrick, G., Andre, F. & Watson, V. Hepatitis B vaccines: assessment of the seroprotective efficacy of two recombinant DNA vaccines. Clin. Ther. 23, 392–403 (2001).

    CAS  PubMed  Google Scholar 

  11. Mast, E. E. et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm. Rep. 55, 1–33 (2006).

    PubMed  Google Scholar 

  12. WHO Publication. Hepatitis B vaccines: WHO position paper—recommendations. Vaccine 28, 589–590 (2009).

  13. Hou, J. K., Velayos, F., Terrault, N. & Mahadevan, U. Viral hepatitis and inflammatory bowel disease. Inflamm. Bowel Dis. 16, 925–932 (2010).

    PubMed  Google Scholar 

  14. Gisbert, J. P., Chaparro, M. & Esteve, M. Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease. Aliment. Pharmacol. Ther. 33, 619–633 (2011).

    CAS  PubMed  Google Scholar 

  15. Moses, J. et al. Hepatitis B immunity and response to booster vaccination in children with inflammatory bowel disease treated with infliximab. Am. J. Gastroenterol. 107, 133–138 (2012).

    CAS  PubMed  Google Scholar 

  16. Melmed, G. Y. et al. Patients with inflammatory bowel disease are at risk for vaccine-preventable illnesses. Am. J. Gastroenterol. 101, 1834–1840 (2006).

    PubMed  Google Scholar 

  17. Melmed, G. Y. Vaccination strategies for patients with inflammatory bowel disease on immunomodulators and biologics. Inflamm. Bowel Dis. 15, 1410–1416 (2009).

    PubMed  Google Scholar 

  18. Wasan, S. K., Baker, S. E., Skolnik, P. R. & Farraye, F. A. A practical guide to vaccinating the inflammatory bowel disease patient. Am. J. Gastroenterol. 105, 1231–1238 (2010).

    PubMed  Google Scholar 

  19. Vida Pérez, L. et al. Adequate rate of response to hepatitis B virus vaccination in patients with inflammatory bowel disease [Spanish]. Med. Clin. (Barc.) 132, 331–335 (2009).

    Google Scholar 

  20. Altunoz, M. E., Senates, E., Yesil, A., Calhan, T. & Ovunc, A. O. Patients with inflammatory bowel disease have a lower response rate to HBV vaccination compared to controls. Dig. Dis. Sci. 57, 1039–1044 (2012).

    PubMed  Google Scholar 

  21. Gisbert, J. P., Villagrasa, J. R., Rodriguez-Nogueiras, A. & Chaparro, M. Efficacy of hepatitis B vaccination and revaccination and factors impacting on response in patients with inflammatory bowel disease. Am. J. Gastroenterol. 107, 1460–1466 (2012).

    CAS  PubMed  Google Scholar 

  22. [No authors listed] Are booster immunisations needed for lifelong hepatitis B immunity? European Consensus Group on Hepatitis B Immunity. Lancet 355, 561–565 (2000).

  23. Brezinschek, H. P., Hofstaetter, T., Leeb, B. F., Haindl, P. & Graninger, W. B. Immunization of patients with rheumatoid arthritis with antitumor necrosis factor alpha therapy and methotrexate. Curr. Opin. Rheumatol. 20, 295–299 (2008).

    CAS  PubMed  Google Scholar 

  24. Shouval, D. Hepatitis B vaccines. J. Hepatol. 39 (Suppl. 1), S70–S76 (2003).

    CAS  PubMed  Google Scholar 

  25. Zuin, G. et al. Impaired response to hepatitis B vaccine in HIV infected children. Vaccine 10, 857–860 (1992).

    CAS  PubMed  Google Scholar 

  26. Scolfaro, C., Fiammengo, P., Balbo, L., Madon, E. & Tovo, P. A. Hepatitis B vaccination in HIV-1-infected children: double efficacy doubling the paediatric dose. AIDS 10, 1169–1170 (1996).

    CAS  PubMed  Google Scholar 

  27. Bruguera, M. et al. Immunogenicity of a yeast-derived hepatitis B vaccine in hemodialysis patients. Am. J. Med. 87, 30S–32S (1989).

    CAS  PubMed  Google Scholar 

  28. Choudhury, S. A. & Peters, V. B. Responses to hepatitis B vaccine boosters in human immunodeficiency virus-infected children. Pediatr. Infect. Dis. J. 14, 65–67 (1995).

    CAS  PubMed  Google Scholar 

  29. Fonseca, M. O., Pang, L. W., de Paula Cavalheiro, N., Barone, A. A. & Heloisa Lopes, M. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine 23, 2902–2908 (2005).

    CAS  PubMed  Google Scholar 

  30. Rey, D. et al. Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV-infected patients. Effects on HIV-1 viral load. Vaccine 18, 1161–1165 (2000).

    CAS  PubMed  Google Scholar 

  31. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2010. Ann. Intern. Med. 152, 36–39 (2010).

  32. Gisbert, J. P. et al. Comparison of the effectiveness of two protocols for vaccination (standard and double dosage) against hepatitis B virus in patients with inflammatory bowel disease. Aliment. Pharmacol. Ther. 35, 1379–1385 (2012).

    CAS  PubMed  Google Scholar 

  33. Lok, A. S. & McMahon, B. J. Chronic hepatitis B. Hepatology 45, 507–539 (2007).

    CAS  PubMed  Google Scholar 

  34. Jack, A. D., Hall, A. J., Maine, N., Mendy, M. & Whittle, H. C. What level of hepatitis B antibody is protective? J. Infect. Dis. 179, 489–492 (1999).

    CAS  PubMed  Google Scholar 

  35. John, T. J. & Cooksley, G. Hepatitis B vaccine boosters: is there a clinical need in high endemicity populations? J. Gastroenterol. Hepatol. 20, 5–10 (2005).

    PubMed  Google Scholar 

  36. Chen, D. S. Hepatitis B vaccination: the key towards elimination and eradication of hepatitis B. J. Hepatol. 50, 805–816 (2009).

    PubMed  Google Scholar 

  37. Chevaux, J. B. et al. Prevalence of hepatitis B and C and risk factors for nonvaccination in inflammatory bowel disease patients in Northeast France. Inflamm. Bowel Dis. 16, 916–924 (2010).

    PubMed  Google Scholar 

  38. Gisbert, J. P., Villagrasa, J. R., Rodríguez-Nogueiras, A. & Chaparro, M. Kinetics of anti-hepatitis B surface antigen titers after hepatitis B vaccination in patients with inflammatory bowel disease. Inflamm. Bowel Dis. http://dx.doi.org/10.1097/MIB.0b013e31827febe9

  39. Floreani, A. et al. Long-term persistence of anti-HBs after vaccination against HBV: an 18 year experience in health care workers. Vaccine 22, 607–610 (2004).

    CAS  PubMed  Google Scholar 

  40. Sezer, S. et al. Factors influencing response to hepatitis B virus vaccination in hemodialysis patients. Transplant. Proc. 32, 607–608 (2000).

    CAS  PubMed  Google Scholar 

  41. Navarro, J. F., Teruel, J. L., Mateos, M. L., Marcen, R. & Ortuno, J. Antibody level after hepatitis B vaccination in hemodialysis patients: influence of hepatitis C virus infection. Am. J. Nephrol. 16, 95–97 (1996).

    CAS  PubMed  Google Scholar 

  42. Zuckerman, J. N., Sabin, C., Craig, F. M., Williams, A. & Zuckerman, A. J. Immune response to a new hepatitis B vaccine in healthcare workers who had not responded to standard vaccine: randomised double blind dose-response study. BMJ 314, 329–333 (1997).

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Goldwater, P. N. Randomized, comparative trial of 20 micrograms vs 40 micrograms Engerix B vaccine in hepatitis B vaccine non-responders. Vaccine 15, 353–356 (1997).

    CAS  PubMed  Google Scholar 

  44. Cardell, K., Akerlind, B., Sallberg, M. & Fryden, A. Excellent response rate to a double dose of the combined hepatitis A and B vaccine in previous nonresponders to hepatitis B vaccine. J. Infect. Dis. 198, 299–304 (2008).

    PubMed  Google Scholar 

  45. Tan, K. L., Goh, K. T., Oon, C. J. & Chan, S. H. Immunogenicity of recombinant yeast-derived hepatitis B vaccine in nonresponders to perinatal immunization. JAMA 271, 859–861 (1994).

    CAS  PubMed  Google Scholar 

  46. Clemens, R. et al. Booster immunization of low- and non-responders after a standard three dose hepatitis B vaccine schedule—results of a post-marketing surveillance. Vaccine 15, 349–352 (1997).

    CAS  PubMed  Google Scholar 

  47. Craven, D. E. et al. Nonresponsiveness to hepatitis B vaccine in health care workers. Results of revaccination and genetic typings. Ann. Intern. Med. 105, 356–360 (1986).

    CAS  PubMed  Google Scholar 

  48. Kim, M. J. et al. Revaccination of healthy nonresponders with hepatitis B vaccine and prediction of seroprotection response. Vaccine 21, 1174–1179 (2003).

    CAS  PubMed  Google Scholar 

  49. Weissman, J. Y. et al. Lack of response to recombinant hepatitis B vaccine in nonresponders to the plasma vaccine. JAMA 260, 1734–1738 (1988).

    CAS  PubMed  Google Scholar 

  50. Hadler, S. C. et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men. N. Engl. J. Med. 315, 209–214 (1986).

    CAS  PubMed  Google Scholar 

  51. Nye, F. J. & Kennedy, N. Update on vaccination guidelines. Br. J. Hosp. Med. 57, 313–318 (1997).

    CAS  PubMed  Google Scholar 

  52. Bertino, J. S. Jr et al. A comparative trial of standard or high-dose S subunit recombinant hepatitis B vaccine versus a vaccine containing S subunit, pre-S1, and pre-S2 particles for revaccination of healthy adult nonresponders. J. Infect. Dis. 175, 678–681 (1997).

    PubMed  Google Scholar 

  53. Lu, Y., Jacobson, D. & Bousvaros, A. Immunizations in patients with inflammatory bowel disease. Inflamm. Bowel Dis. 15, 1417–1423 (2009).

    PubMed  Google Scholar 

  54. Hall, A. J. Boosters for hepatitis B vaccination? Need for an evidence-based policy. Hepatology 51, 1485–1486 (2010).

    PubMed  Google Scholar 

  55. West, D. J. & Calandra, G. B. Vaccine induced immunologic memory for hepatitis B surface antigen: implications for policy on booster vaccination. Vaccine 14, 1019–1027 (1996).

    CAS  PubMed  Google Scholar 

  56. Stevens, C. E. et al. Hepatitis B vaccine in patients receiving hemodialysis. Immunogenicity and efficacy. N. Engl. J. Med. 311, 496–501 (1984).

    CAS  PubMed  Google Scholar 

  57. Palefsky, J. Human papilloma virus infection in HIV-infected persons. Top. HIV Med. 15, 130–133 (2007).

    PubMed  Google Scholar 

  58. Munoz, C. Human papillomavirus and cancer: the epidemiological evidence. J. Clin. Virol. 19, 1–5 (2000).

    CAS  PubMed  Google Scholar 

  59. Munoz, N. et al. Epidemiology classification of human papillomavirus types associated with cervical cancer. N. Engl. J. Med. 348, 518–527 (2003).

    PubMed  Google Scholar 

  60. Sinclair, J. A., Wasan, S. K. & Farraye, F. A. Health maintenance in the inflammatory bowel disease patient. Gastroenterol. Clin. N. Am. 41, 325–337 (2012).

    Google Scholar 

  61. Harper, D. M. et al. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 367, 1247–1255 (2006).

    CAS  PubMed  Google Scholar 

  62. Villa, L. L. et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol. 6, 271–278 (2005).

    PubMed  Google Scholar 

  63. Arbyn, M. & Dillner, J. Review of current knowledge on HPV vaccination: an appendix to the European Guidelines for Quality Assurance in Cervical Cancer Screening. J. Clin. Virol. 38, 189–197 (2007).

    PubMed  Google Scholar 

  64. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009*. Ann. Intern. Med. 150, 40–44 (2009).

  65. deBruyn, J. C. et al. Immunogenicity and safety of influenza vaccination in children with inflammatory bowel disease. Inflamm. Bowel Dis. 18, 25–33 (2012).

    PubMed  Google Scholar 

  66. Schanzer, D. L., Langley, J. M. & Tam, T. W. Role of influenza and other respiratory viruses in admissions of adults to Canadian hospitals. Influenza Other Respi. Viruses 2, 1–8 (2008).

    Google Scholar 

  67. Schanzer, D. L., Langley, J. M. & Tam, T. W. Hospitalization attributable to influenza and other viral respiratory illnesses in Canadian children. Pediatr. Infect. Dis. J. 25, 795–800 (2006).

    PubMed  Google Scholar 

  68. Billings, J. L., Hertz, M. I., Savik, K. & Wendt, C. H. Respiratory viruses and chronic rejection in lung transplant recipients. J. Heart. Lung Transplant. 21, 559–566 (2002).

    PubMed  Google Scholar 

  69. Hassan, I. A., Chopra, R., Swindell, R. & Mutton, K. J. Respiratory viral infections after bone marrow/peripheral stem-cell transplantation: the Christie hospital experience. Bone Marrow Transplant. 32, 73–77 (2003).

    CAS  PubMed  Google Scholar 

  70. Fiore, A. E. et al. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR Recomm. Rep. 56, 1–54 (2007).

    PubMed  Google Scholar 

  71. Lu, Y. et al. Immune response to influenza vaccine in children with inflammatory bowel disease. Am. J. Gastroenterol. 104, 444–453 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Mamula, P. et al. Immune response to influenza vaccine in pediatric patients with inflammatory bowel disease. Clin. Gastroenterol. Hepatol. 5, 851–856 (2007).

    PubMed  Google Scholar 

  73. Cullen, G., Bader, C., Korzenik, J. R. & Sands, B. E. Serological response to the 2009 H1N1 influenza vaccination in patients with inflammatory bowel disease. Gut 61, 385–391 (2012).

    PubMed  Google Scholar 

  74. Targonski, P. V. & Poland, G. A. Pneumococcal vaccination in adults: recommendations, trends, and prospects. Cleve. Clin. J. Med. 74, 401–406, 408–410, 413–414 (2007).

    PubMed  Google Scholar 

  75. Melmed, G. Y. et al. Immunosuppression impairs response to pneumococcal polysaccharide vaccination in patients with inflammatory bowel disease. Am. J. Gastroenterol. 105, 148–154 (2010).

    PubMed  Google Scholar 

  76. Dotan, I. et al. Normal response to vaccines in inflammatory bowel disease patients treated with thiopurines. Inflamm. Bowel Dis. 18, 261–268 (2012).

    PubMed  Google Scholar 

  77. Brogan, M. D., Shanahan, F., Oliver, M., Stevens, R. H. & Targan, S. R. Defective memory B cell formation in patients with inflammatory bowel disease following tetanus toxoid booster immunization. J. Clin. Lab. Immunol. 24, 69–74 (1987).

    CAS  PubMed  Google Scholar 

  78. Nielsen, H. J. et al. Increased levels of specific leukocyte- and platelet-derived substances during normal anti-tetanus antibody synthesis in patients with inactive Crohn disease. Scand. J. Gastroenterol. 36, 265–269 (2001).

    CAS  PubMed  Google Scholar 

  79. Bernstein, C. N., Rawsthorne, P. & Blanchard, J. F. Population-based case-control study of measles, mumps, and rubella and inflammatory bowel disease. Inflamm. Bowel Dis. 13, 759–762 (2007).

    PubMed  Google Scholar 

  80. [No authors listed] Prevention of varicella: recommendations of the Advisory Committee of Immunization Practice (ACIP). Centers for Disease Control and Prevention. MMWR Recomm. Rep. 45, 1–36 (1996).

  81. Marin, M., Guris, D. & Chaves, S. S. Prevention of varicella: recommendation of the Advisory Committee on Immunization Practice (ACIP). MMWR Recomm. Rep. 56, 1–40 (2007).

    PubMed  Google Scholar 

  82. Gupta, G., Lautenbach, E. & Lewis, J. D. Incidence and risk factors for herpes zoster among patients with inflammatory bowel disease. Clin. Gastroenterol. Hepatol. 4, 1483–1490 (2006).

    PubMed  Google Scholar 

  83. Moscandrew, M., Mahadevan, U. & Kane, S. General health maintenance in IBD. Inflamm. Bowel Dis. 15, 1399–1409 (2009).

    PubMed  Google Scholar 

  84. Harpaz, R., Ortega-Sánchez, I. R. & Seward, J. F. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep. 57, 1–30 (2008).

    PubMed  Google Scholar 

  85. Kotton, C. N. Nailing down the shingles in IBD. Inflamm. Bowel Dis. 13, 1178–1179 (2007).

    PubMed  Google Scholar 

  86. Singh, A. & Englund, K. Q: Who should receive the shingles vaccine? Cleve. Clin. J. Med. 76, 45–48 (2009).

    PubMed  Google Scholar 

  87. Zhang, J. et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases. JAMA 308, 43–49 (2012).

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Chaparro, M. & Gisbert, J. P. Transplacental transfer of immunosuppressants and biologics used for the treatment of inflammatory bowel disease. Curr. Pharm. Biotechnol. 12, 765–773 (2011).

    CAS  PubMed  Google Scholar 

  89. Dubinsky, M., Abraham, B. & Mahadevan, U. Management of the pregnant IBD patient. Inflamm. Bowel Dis. 14, 1736–1750 (2008).

    PubMed  Google Scholar 

  90. Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0 through 18 years—United States, 2009. MMWR 57 (2008).

  91. Anderson, E. J. Rotavirus vaccines: viral shedding and risk of transmission. Lancet Infect. Dis. 8, 642–649 (2008).

    PubMed  Google Scholar 

  92. Kroger, A. T., Atkinson, W. L., Marcuse, E. K. & Pickering, L. K. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep. 55, 1–48 (2006).

    PubMed  Google Scholar 

  93. Parashar, U. D., Alexander, J. P. & Glass, R. I. Prevention of rotavirus gastroenteritis among infants and children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep. 55, 1–13 (2006).

    PubMed  Google Scholar 

  94. Yeung, J. H., Goodman, K. J. & Fedorak, R. N. Inadequate knowledge of immunization guidelines: a missed opportunity for preventing infection in immunocompromised IBD patients. Inflamm. Bowel Dis. 18, 34–40 (2012).

    PubMed  Google Scholar 

  95. Melmed, G. Y. Immunizations and IBD: whose responsibility is it? If I'm the prescribing doctor, shouldn't it be mine? Inflamm. Bowel Dis. 18, 41–42 (2012).

    PubMed  Google Scholar 

  96. Wilckens, V. et al. The immunization status of patients with IBD is alarmingly poor before the introduction of specific guidelines. Scand. J. Gastroenterol. 46, 855–861 (2011).

    PubMed  Google Scholar 

  97. Wasan, S. K., Coukos, J. A. & Farraye, F. A. Vaccinating the inflammatory bowel disease patient: deficiencies in gastroenterologists knowledge. Inflamm. Bowel Dis. 17, 2536–2540 (2011).

    PubMed  Google Scholar 

  98. Gupta, A., Macrae, F. A. & Gibson, P. R. Vaccination and screening for infections in patients with inflammatory bowel disease: a survey of Australian gastroenterologists. Intern. Med. J. 41, 462–467 (2011).

    CAS  PubMed  Google Scholar 

  99. Loras, C. et al. Prevalence and factors related to hepatitis B and C in inflammatory bowel disease patients in Spain: a nationwide, multicenter study. Am. J. Gastroenterol. 104, 57–63 (2009).

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastroenterology Unit, Hospital Universitario de La Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Diego de Léon 62, Madrid, 28006, Spain

    Javier P. Gisbert & María Chaparro

Authors
  1. Javier P. Gisbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. María Chaparro
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Both authors contributed to all aspects of this manuscript.

Corresponding author

Correspondence to Javier P. Gisbert.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gisbert, J., Chaparro, M. Vaccination strategies in patients with IBD. Nat Rev Gastroenterol Hepatol 10, 277–285 (2013). https://doi.org/10.1038/nrgastro.2013.28

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrgastro.2013.28

This article is cited by

Search

Advanced search

Quick links

Nature Briefing Microbiology

Sign up for the Nature Briefing: Microbiology newsletter — what matters in microbiology research, free to your inbox weekly.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing: Microbiology