Expert consensus on vaccination in patients with inflammatory bowel disease in Japan

Takashi Ishige; Toshiaki Shimizu; Kenji Watanabe; Katsuhiro Arai; Koichi Kamei; Takahiro Kudo; Reiko Kunisaki; Daisuke Tokuhara; Makoto Naganuma; Tatsuki Mizuochi; Atsuko Murashima; Yuta Inoki; Naomi Iwata; Itaru Iwama; Sachi Koinuma; Hirotaka Shimizu; Keisuke Jimbo; Yugo Takaki; Shohei Takahashi; Yuki Cho; Ryusuke Nambu; Daisuke Nishida; Shin-Ichiro Hagiwara; Norikatsu Hikita; Hiroki Fujikawa; Kenji Hosoi; Shuhei Hosomi; Yohei Mikami; Jun Miyoshi; Ryusuke Yagi; Yoko Yokoyama; Tadakazu Hisamatsu

doi:10.1007/s00535-022-01953-w

Expert consensus on vaccination in patients with inflammatory bowel disease in Japan

J Gastroenterol. 2023 Feb;58(2):135-157. doi: 10.1007/s00535-022-01953-w. Epub 2023 Jan 11.

Authors

Takashi Ishige¹, Toshiaki Shimizu², Kenji Watanabe³, Katsuhiro Arai⁴, Koichi Kamei⁵, Takahiro Kudo⁶, Reiko Kunisaki⁷, Daisuke Tokuhara⁸, Makoto Naganuma⁹, Tatsuki Mizuochi¹⁰, Atsuko Murashima¹¹, Yuta Inoki⁵, Naomi Iwata¹², Itaru Iwama¹³, Sachi Koinuma¹⁴, Hirotaka Shimizu⁴, Keisuke Jimbo⁶, Yugo Takaki¹⁵, Shohei Takahashi¹⁶, Yuki Cho¹⁷, Ryusuke Nambu¹³, Daisuke Nishida⁷, Shin-Ichiro Hagiwara¹⁸, Norikatsu Hikita¹⁷, Hiroki Fujikawa⁴, Kenji Hosoi¹⁹, Shuhei Hosomi²⁰, Yohei Mikami²¹, Jun Miyoshi²², Ryusuke Yagi²³, Yoko Yokoyama²⁴, Tadakazu Hisamatsu²²

Affiliations

¹ Department of Pediatrics, Gunma University Graduate School of Medicine, 3-39-22, Showa-Machi, Maebashi, Gunma, 371-8511, Japan. ishiget@gunma-u.ac.jp.
² Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
³ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Japan.
⁴ Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan.
⁵ Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan.
⁶ Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
⁷ Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan.
⁸ Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.
⁹ Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan.
¹⁰ Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
¹¹ Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center of Child Health and Development, Tokyo, Japan.
¹² Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan.
¹³ Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan.
¹⁴ Japan Drug Information Institute in Pregnancy, National Center of Child Health and Development, Tokyo, Japan.
¹⁵ Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
¹⁶ Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan.
¹⁷ Department of Pediatrics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
¹⁸ Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Osaka, Japan.
¹⁹ Division of Gastroenterology, Tokyo Metro Children's Medical Center, Tokyo, Japan.
²⁰ Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
²¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
²² Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.
²³ Department of Pediatrics, Gunma University Graduate School of Medicine, 3-39-22, Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
²⁴ Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.

Abstract

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.

Keywords: Crohn’s disease; Immunization; Ulcerative colitis; Vaccine-preventable disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Child
Consensus
Female
Humans
Inflammatory Bowel Diseases* / drug therapy
Japan
Pregnancy
Vaccination / adverse effects

Grants and funding

20316729/Ministry of Health, Labour and Welfare