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Original Article
- IBD
- Live-attenuated vaccination in patients with inflammatory bowel disease while continuing or after elective switch to vedolizumab
- Hisashi Shiga, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Rintaro Moroi, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
- Intest Res 2024;22(3):378-386. Published online March 26, 2024
- DOI: https://doi.org/10.5217/ir.2023.00203
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Abstract
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ePub - Background/Aims
Vedolizumab (VDZ) is a gut-selective agent with a favorable safety profile. We aimed to assess the feasibility of elective switch from other advanced therapies to VDZ and subsequent live-attenuated vaccination while continuing VDZ in patients with inflammatory bowel diseases (IBD).
Methods
We measured antibody titers specific for measles, rubella, mumps, and varicella viruses in IBD patients under immunosuppressive therapy. Those with negative titers and without vaccination history were judged unimmunized. Patients were administered vaccines while continuing VDZ or switched to VDZ if receiving other advanced therapies and then administered vaccines. Co-primary outcomes were the rate of maintaining disease severity after vaccination and the rate without vaccine-induced infection.
Results
Among 107 unimmunized patients, 37 agreed to receive live-attenuated vaccines while continuing VDZ (17 patients) or after switching to VDZ (20 patients). In the 20 patients who electively switched to VDZ, disease severity was maintained except for 1 patient who developed intestinal infection. After 54 weeks, 18 patients (90%) continued to receive VDZ, excluding 2 patients who reverted to their originally administered biologics. In all 37 patients administered live-attenuated vaccines under VDZ treatment, disease severity was maintained after vaccination. Antibody titers became positive or equivocal in 34 patients (91.9%). There were no cases of vaccine-induced infection during a median observation period of 121 weeks.
Conclusions
While live-attenuated vaccines are contraindicated under immunosuppressive therapy, they may be safely administered while receiving VDZ immunotherapy. Switching from other advanced therapies to VDZ and subsequently receiving live-attenuated vaccines may be a safe alternative in unimmunized patients. -
Citations
Citations to this article as recorded by
- Safety of Live Attenuated MMR, Varicella, and Yellow Fever Vaccination in Patients with Inflammatory Bowel Disease Receiving Biologic and Targeted Synthetic Therapy: A Propensity-Score-Matched Analysis
Niven Wang, Abdelrahman Yousef, Kevin Nguyen, Timothy Mok, Mahmoud Yousef, Ahmed Telbany, Abu Baker Sheikh, Christopher Chang, Swathi Paleti
Vaccines.2026; 14(6): 474. CrossRef - Timing of Live-Attenuated Vaccination in Patients with Inflammatory Bowel Disease Receiving Biologics: A Comparison of International Guidelines and Regulatory Labeling
Yohei Manabe, Hideharu Hagiya
Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences).2026; 52(6): 311. CrossRef - ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease
Henit Yanai, Pierre Ellul, Bram Verstockt, Thomas Greuter, Uri Kopylov, María José Casanova, Gabriele Dragoni, Piotr Eder, Maria Manuela Estevinho, Candida Abreu, Federica Furfaro, Christina Kapizioni, Konstantinos Karmiris, Konstantinos Katsanos, Julien
Journal of Crohn's and Colitis.2026;[Epub] CrossRef - Live Typhoid and Yellow Fever Vaccines Administered to a Patient With Ulcerative Colitis on Vedolizumab
Yash Hegde, Mary S. Hayney, Freddy Caldera
ACG Case Reports Journal.2024; 11(10): e01507. CrossRef
- Safety of Live Attenuated MMR, Varicella, and Yellow Fever Vaccination in Patients with Inflammatory Bowel Disease Receiving Biologic and Targeted Synthetic Therapy: A Propensity-Score-Matched Analysis
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