{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:42:06Z","timestamp":1783539726777,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with inflammatory bowel disease (IBD) have low vaccination rates for vaccine-preventable diseases. Fear of adverse reactions (AEs) appear to negatively affect vaccination efforts. We aimed to systemically review the risks for AEs following immunization for patients with IBD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched PubMed and Embase until April 15, 2020, for studies evaluating the safety of vaccinations among patients with IBD. The primary outcome was the incidence of systemic and local AEs among vaccinated patients. Secondary outcome was the rate of IBD flare following immunization. We utilized a random effects meta-analysis of proportions using the DerSimonian-Laird approach to estimate the safety of immunizations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 13 studies with 2116 patients was included in our analysis after fulfilling our inclusion criteria. Seven studies examined the influenza vaccine, 4 the pneumococcal vaccine, 1 the recombinant zoster vaccine, and 1 the hepatitis B vaccine. Follow-up of patients was up to 6 months. The majority of AEs were local, with a pooled incidence of 24% (95% CI, 9%-42%) for all vaccines. Systemic AEs were mostly mild, without resulting in hospitalizations or deaths, with a pooled incidence of 16% (95% CI, 6%-29%) for all vaccines. Flare of inflammatory bowel disease after vaccination found with a pooled incidence of 2% (95% CI, 1%-4%) and we include in the analysis data from all immunizations examined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our study demonstrated that AEs after vaccination are mainly local or mildly systemic and do not differ significantly from the expected AE after recommended immunizations for the general population. Thus, gastroenterologists should reinforce that vaccines are safe in patients with IBD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izab266","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T05:51:51Z","timestamp":1638337911000},"page":"1430-1442","source":"Crossref","is-referenced-by-count":18,"title":["Safety of Immunizations for the Adult Patient With Inflammatory Bowel Disease\u2014A Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-8568","authenticated-orcid":false,"given":"Athanasios","family":"Desalermos","sequence":"first","affiliation":[{"name":"University of Massachusetts Medical School, Center for Digestive Wellness , Worcester, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pimienta","sequence":"additional","affiliation":[{"name":"The Keck School of Medicine at University of Southern California , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markos","family":"Kalligeros","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Shehadeh","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Diamantopoulos","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine , Pittsburgh, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Karamanolis","sequence":"additional","affiliation":[{"name":"University of Athens School of Medicine , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1960-6611","authenticated-orcid":false,"given":"Freddy","family":"Caldera","sequence":"additional","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health , Madison, WI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis A","family":"Farraye","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"2023112019094518000_CIT0001","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/apt.15685","article-title":"Systematic review and meta-analysis: efficacy and safety of early biologic treatment in adult and paediatric patients with Crohn\u2019s disease.","volume":"51","author":"Ungaro","year":"2020","journal-title":"Aliment Pharmacol Ther."},{"key":"2023112019094518000_CIT0002","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/j.cgh.2020.01.017","article-title":"Positioning therapies in ulcerative colitis.","volume":"18","author":"Danese","year":"2020","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2023112019094518000_CIT0003","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1053\/j.gastro.2018.04.012","article-title":"Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases.","volume":"155","author":"Kirchgesner","year":"2018","journal-title":"Gastroenterology."},{"key":"2023112019094518000_CIT0004","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s11938-018-0200-4","article-title":"Update on vaccinating the patient with inflammatory bowel disease.","volume":"16","author":"Coukos","year":"2018","journal-title":"Curr Treat Options Gastroenterol."},{"key":"2023112019094518000_CIT0005","first-page":"717","article-title":"Vaccination and health maintenance issues to consider in patients with inflammatory bowel disease.","volume":"13","author":"Reich","year":"2017","journal-title":"Gastroenterol Hepatol (N Y)."},{"key":"2023112019094518000_CIT0006","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/ajg.2016.537","article-title":"ACG clinical guideline: preventive care in inflammatory bowel disease.","volume":"112","author":"Farraye","year":"2017","journal-title":"Am J Gastroenterol."},{"key":"2023112019094518000_CIT0007","doi-asserted-by":"crossref","first-page":"374","DOI":"10.7326\/M20-8080","article-title":"Recommended adult immunization schedule, United States, 2021.","volume":"174","author":"Freedman","year":"2021","journal-title":"Ann Intern Med."},{"key":"2023112019094518000_CIT0008","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/ibd\/izaa055","article-title":"Optimizing immunization strategies in patients with IBD.","volume":"27","author":"Caldera","year":"2021","journal-title":"Inflamm Bowel Dis."},{"key":"2023112019094518000_CIT0009","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/01.MIB.0000437737.68841.87","article-title":"Immunization rates and vaccine beliefs among patients with inflammatory bowel disease: an opportunity for improvement.","volume":"20","author":"Wasan","year":"2014","journal-title":"Inflamm Bowel Dis."},{"key":"2023112019094518000_CIT0010","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1007\/s10620-019-05494-w","article-title":"Receipt of preventive care services among US adults with inflammatory bowel disease, 2015-2016.","volume":"647","author":"Xu","year":"2019","journal-title":"Dig Dis Sci."},{"key":"2023112019094518000_CIT0011","first-page":"1","article-title":"Surveillance of influenza vaccination coverage\u2013United States, 2007-08 through 2011-12 influenza seasons.","volume":"62","author":"Lu","year":"2013","journal-title":"MMWR Surveill Summ."},{"key":"2023112019094518000_CIT0012","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/003335491312800103","article-title":"Strategies to achieve the healthy people 2020 annual influenza vaccine coverage goal for health-care personnel: recommendations from the national vaccine advisory committee.","volume":"1281","author":"National Vaccine Advisory Committee","year":"2013","journal-title":"Public Health Rep."},{"key":"2023112019094518000_CIT0013","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s10620-010-1329-8","article-title":"Are primary care providers uncomfortable providing routine preventive care for inflammatory bowel disease patients?","volume":"56","author":"Selby","year":"2011","journal-title":"Dig Dis Sci."},{"key":"2023112019094518000_CIT0014","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1093\/ecco-jcc\/jjv064","article-title":"Vaccination in inflammatory bowel disease patients: attitudes, knowledge, and uptake.","volume":"9","author":"Malhi","year":"2015","journal-title":"J Crohns Colitis."},{"key":"2023112019094518000_CIT0015","doi-asserted-by":"crossref","first-page":"otaa056","DOI":"10.1093\/crocol\/otaa056","article-title":"Vaccination rates and family barriers among children with inflammatory bowel disease.","volume":"2","author":"Holland","year":"2020","journal-title":"Crohn\u2019s Colitis 360"},{"key":"2023112019094518000_CIT0016","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.","volume":"283","author":"Stroup","year":"2000","journal-title":"Jama."},{"key":"2023112019094518000_CIT0017","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1136\/gut.2010.233981","article-title":"H1N1 vaccines in a large observational cohort of patients with inflammatory bowel disease treated with immunomodulators and biological therapy.","volume":"60","author":"Rahier","year":"2011","journal-title":"Gut."},{"key":"2023112019094518000_CIT0018","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.14309\/ajg.0000000000000289","article-title":"High immunogenicity of the pneumococcal conjugated vaccine in immunocompromised adults with inflammatory bowel disease.","volume":"114","author":"Pittet","year":"2019","journal-title":"Am J Gastroenterol."},{"key":"2023112019094518000_CIT0019","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1136\/gutjnl-2011-300256","article-title":"Serological response to the 2009 H1N1 influenza vaccination in patients with inflammatory bowel disease.","volume":"613","author":"Cullen","year":"2012","journal-title":"Gut."},{"key":"2023112019094518000_CIT0020","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1007\/s00535-015-1042-7","article-title":"Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial.","volume":"50","author":"Matsumoto","year":"2015","journal-title":"J Gastroenterol."},{"key":"2023112019094518000_CIT0021","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1097\/MIB.0000000000000615","article-title":"Immunogenicity of influenza vaccine for patients with inflammatory bowel disease on maintenance infliximab therapy: a randomized trial.","volume":"22","author":"deBruyn","year":"2016","journal-title":"Inflamm Bowel Dis."},{"key":"2023112019094518000_CIT0022","first-page":"593","article-title":"Immunogenicity of high dose influenza vaccine for patients with inflammatory bowel disease on anti-TNF monotherapy: a randomized clinical trial.","volume":"26","author":"Caldera","year":"2020","journal-title":"Inflamm Bowel Dis."},{"key":"2023112019094518000_CIT0023","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1093\/ecco-jcc\/jjv152","article-title":"Immunogenicity and safety of influenza vaccine in inflammatory bowel disease patients treated or not with immunomodulators and\/or biologics: a two-year prospective study.","volume":"9","author":"Launay","year":"2015","journal-title":"J Crohns Colitis."},{"key":"2023112019094518000_CIT0024","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.crohns.2013.09.022","article-title":"Patients with Crohn\u2019s disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccine.","volume":"8","author":"Lee","year":"2014","journal-title":"J Crohns Colitis."},{"key":"2023112019094518000_CIT0025","doi-asserted-by":"crossref","first-page":"5464","DOI":"10.1016\/j.vaccine.2015.08.011","article-title":"Immunosuppressive drugs impairs antibody response of the polysaccharide and conjugated pneumococcal vaccines in patients with Crohn\u2019s disease.","volume":"33","author":"Kants\u00f8","year":"2015","journal-title":"Vaccine."},{"key":"2023112019094518000_CIT0026","doi-asserted-by":"crossref","first-page":"2986","DOI":"10.1007\/s10620-019-06016-4","article-title":"Safety of recombinant zoster vaccine in patients with inflammatory bowel disease.","volume":"65","author":"Satyam","year":"2020","journal-title":"Dig Dis Sci."},{"key":"2023112019094518000_CIT0027","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1002\/ibd.21800","article-title":"Effects of immunosuppression on immune response to pneumococcal vaccine in inflammatory bowel disease: a prospective study.","volume":"18","author":"Fiorino","year":"2012","journal-title":"Inflamm Bowel Dis."},{"key":"2023112019094518000_CIT0028","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.crohns.2012.05.011","article-title":"Immune response to influenza A\/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-\u03b1 agents: effects of combined therapy with immunosuppressants.","volume":"7","author":"Andrisani","year":"2013","journal-title":"J Crohns Colitis."},{"key":"2023112019094518000_CIT0029","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/ecco-jcc\/jjw046","article-title":"Sci-B-VacTM Vs ENGERIX-B vaccines for hepatitis B virus in patients with inflammatory bowel diseases: a randomised controlled trial.","volume":"10","author":"Etzion","year":"2016","journal-title":"J Crohns Colitis."},{"key":"2023112019094518000_CIT0030","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1155\/2012\/158362","article-title":"An audit of influenza vaccination status in adults with inflammatory bowel disease.","volume":"26","author":"Narula","year":"2012","journal-title":"Can J Gastroenterol."},{"key":"2023112019094518000_CIT0031","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1080\/21645515.2017.1423153","article-title":"Influenza vaccines: evaluation of the safety profile.","volume":"14","author":"Trombetta","year":"2018","journal-title":"Hum Vaccin Immunother."},{"key":"2023112019094518000_CIT0032","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1016\/S1473-3099(20)30130-4","article-title":"The state of vaccine safety science: systematic reviews of the evidence.","volume":"20","author":"Dudley","year":"2020","journal-title":"Lancet Infect Dis."},{"key":"2023112019094518000_CIT0033","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.gastrohep.2015.09.014","article-title":"Adherence to a predefined vaccination program in patients with inflammatory bowel disease.","volume":"39","author":"Ruiz-Cuesta","year":"2016","journal-title":"Gastroenterol Hepatol."},{"key":"2023112019094518000_CIT0034","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.4161\/hv.29020","article-title":"Impact of a physician recommendation.","volume":"10","author":"Darden","year":"2014","journal-title":"Hum Vaccin Immunother."},{"key":"2023112019094518000_CIT0035","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1007\/s10620-011-1671-5","article-title":"Relapse rate following azathioprine withdrawal in maintaining remission for Crohn\u2019s disease: a meta-analysis.","volume":"56","author":"French","year":"2011","journal-title":"Dig Dis Sci."},{"key":"2023112019094518000_CIT0036","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1136\/bmj.38449.476759.AE","article-title":"MMR vaccine and Crohn\u2019s disease: ecological study of hospital admissions in England, 1991 to 2002.","volume":"3307500","author":"Seagroatt","year":"2005","journal-title":"BMJ."},{"key":"2023112019094518000_CIT0037","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.cgh.2015.04.179","article-title":"Vaccination and risk for developing inflammatory bowel disease: a meta-analysis of case-control and cohort studies.","volume":"138","author":"Pineton de Chambrun","year":"2015","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2023112019094518000_CIT0038","first-page":"247","article-title":"Improving immunization strategies in patients with inflammatory bowel disease.","volume":"32","author":"Farshidpour","year":"2019","journal-title":"Ann Gastroenterol."},{"key":"2023112019094518000_CIT0039","doi-asserted-by":"crossref","first-page":"otaa057","DOI":"10.1093\/crocol\/otaa057","article-title":"Is it time for pediatric and adult gastroenterologists to assume responsibility for providing vaccinations?","volume":"23","author":"Rolak","year":"2020","journal-title":"Crohn\u2019s & Colitis 360."},{"key":"2023112019094518000_CIT0040","doi-asserted-by":"crossref","first-page":"otz039","DOI":"10.1093\/crocol\/otz039","article-title":"The use of An EHR patient portal (mychart-epic) in patients with inflammatory bowel disease.","volume":"13","author":"Reich","year":"2019","journal-title":"Crohn\u2019s & Colitis 360."},{"key":"2023112019094518000_CIT0041","first-page":"CD003941","article-title":"Patient reminder and recall interventions to improve immunization rates.","volume":"1","author":"Jacobson Vann","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"2023112019094518000_CIT0042","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1136\/gutjnl-2020-321411","article-title":"Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study.","volume":"69","author":"Bezzio","year":"2020","journal-title":"Gut."}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/28\/9\/1430\/53600010\/izab266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/28\/9\/1430\/53600010\/izab266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T20:53:55Z","timestamp":1700513635000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/28\/9\/1430\/6438176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,24]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,11,24]]},"published-print":{"date-parts":[[2022,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izab266","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,1]]},"published":{"date-parts":[[2021,11,24]]}}}