Abstract
Incidence of inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing worldwide. Children with IBDs have a dysfunctional immune system and they are frequently treated with immunomodulating drugs and biological therapy, which significantly impair immune system functions and lead to an increased risk of infections. Vaccines are essential to prevent at least part of these infections and this explains why strict compliance to the immunization guidelines specifically prepared for IBD patients is strongly recommended. However, several factors might lead to insufficient immunization. In this paper, present knowledge on the use of vaccines in children with IBDs is discussed. Literature review showed that despite a lack of detailed quantification of the risk of infections in children with IBDs, these children might have infections more frequently than age-matched healthy subjects, and at least in some cases, these infections might be even more severe. Fortunately, most of these infections could be prevented when recommended schedules of immunization are carefully followed. Vaccines given to children with IBDs generally have adequate immunogenicity and safety. Attention must be paid to live attenuated vaccines that can be administered only to children without or with mild immune system function impairment. Vaccination of their caregivers is also recommended. Unfortunately, compliance to these recommendations is generally low and multidisciplinary educational programs to improve vaccination coverage must be planned, in order to protect children with IBD from vaccine-preventable diseases.
Highlights
Inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), are a group of immune-mediated chronic conditions that are presumed to occur in genetically susceptible subjects due to a dysregulated intestinal immune response to a number of environmental factors [1]
This study showed that vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (MMR) (89.3%), Haemophilus influenzae type b (Hib) (81.9%), meningococcus C (23.5%), varicella (18.4%), pneumococcus (18.6%), papillomavirus (HPV) (5.9%), and rotavirus (1.9%) vaccines
These data showed the importance of educational interventions, including manuscripts, that highlight the risks of vaccine-preventable diseases, as well as the efficacy and the safety of vaccines in patients with IBD
Summary
Inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), are a group of immune-mediated chronic conditions that are presumed to occur in genetically susceptible subjects due to a dysregulated intestinal immune response to a number of environmental factors [1]. As evidenced in adults with IBDs [11], even in children, several factors might lead to insufficient immunization To reduce this risk, a specific immunization schedule must be followed. Genetic variants of IBD-specific loci found in IBD patients can impair all these functions, leading to abnormal immune response with increased risk of infection and poor response to antigen stimulation, including vaccine administration [14]. UC is usually viewed as a Th2-type condition because of the increased intestinal expression of excessive Th2 response, with upregulated secretion of IL-5, IL-4, IL-10, and IL-13 [15] In both cases, overexpression of pro-inflammatory cytokines was found to be associated with the initiation and progression of IBDs [16]. Protecting this group of patients against infections is of upmost importance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
