Department of Pediatrics, Gunma University Graduate School of Medicine, 3-39-22, Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
J Gastroenterol. 2023 Feb;58(2):135-157. doi: 10.1007/s00535-022-01953-w. Epub 2023 Jan 11.
Immunosuppressive therapies can affect the immune response to or safety of vaccination in patients with inflammatory bowel disease (IBD). The appropriateness of vaccination should be assessed prior to the initiation of IBD treatment because patients with IBD frequently undergo continuous treatment with immunosuppressive drugs. This consensus was developed to support the decision-making process regarding appropriate vaccination for pediatric and adult patients with IBD and physicians by providing critical information according to the published literature and expert consensus about vaccine-preventable diseases (VPDs) [excluding cervical cancer and coronavirus disease 2019 (COVID-19)] in Japan. This consensus includes 19 important clinical questions (CQs) on the following 4 topics: VPDs (6 CQs), live attenuated vaccines (2 CQs), inactivated vaccines (6 CQs), and vaccination for pregnancy, childbirth, and breastfeeding (5 CQs). These topics and CQs were selected under unified consensus by the members of a committee on intractable diseases with support by a Health and Labour Sciences Research Grant. Physicians should provide necessary information on VPDs to their patients with IBD and carefully manage these patients' IBD if various risk factors for the development or worsening of VPDs are present. This consensus will facilitate informed and shared decision-making in daily IBD clinical practice.
免疫抑制疗法会影响炎症性肠病 (IBD) 患者对疫苗的免疫反应或安全性。在开始 IBD 治疗之前,应评估疫苗接种的适宜性,因为 IBD 患者经常接受免疫抑制药物的持续治疗。本共识旨在通过根据日本已发表的文献和专家共识提供有关疫苗可预防疾病(VPD)[不包括宫颈癌和 2019 年冠状病毒病(COVID-19)]的关键信息,为儿科和成人 IBD 患者及其医生的疫苗接种决策过程提供支持。本共识包括以下 4 个主题的 19 个重要临床问题(CQ):VPD(6 个 CQ)、减毒活疫苗(2 个 CQ)、灭活疫苗(6 个 CQ)以及妊娠、分娩和哺乳期的疫苗接种(5 个 CQ)。这些主题和 CQ 是在一项由健康和劳动科学研究补助金支持的难治性疾病委员会成员的统一共识下选择的。如果存在 VPD 发展或恶化的各种危险因素,医生应向患有 IBD 的患者提供有关 VPD 的必要信息,并仔细管理这些患者的 IBD。本共识将有助于在日常 IBD 临床实践中做出知情和共同决策。