{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:12:46Z","timestamp":1779804766242,"version":"3.53.1"},"reference-count":20,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Introduction: Live attenuated vaccines (LAVs) are generally avoided in patients with inflammatory bowel disease (IBD) receiving immunomodulatory therapy due to concerns about infection risk. However, real-world data evaluating their safety in this population remain limited. We aimed to assess adverse outcomes following LAV administration in IBD patients treated with biologic agents. Methods: We conducted a retrospective cohort study using the TriNetX multi-institutional database. Adults with IBD receiving immunomodulatory therapy were categorized into two cohorts: those who received an LAV and those who did not. Biologic therapies included tumor necrosis factor inhibitors (infliximab, and adalimumab), integrin antagonists (vedolizumab), interleukin (IL)-12\/23 inhibitors (ustekinumab), IL-23 inhibitors (risankizumab, and guselkumab), and Janus kinase inhibitors (tofacitinib, and upadacitinib). LAVs included measles\u2013mumps\u2013rubella (MMR), varicella (Varivax), and yellow fever vaccines. Propensity score matching was performed based on age, sex, IBD subtype (Crohn\u2019s disease vs. ulcerative colitis), and biologic class. Patients with outcomes prior to the risk window were excluded. Adverse outcomes within six months included hospitalization, emergency department (ED) visits, fever, rash, and encephalitis. Results: A total of 672 patients were included in each propensity-score-matched cohort. Live attenuated vaccine (LAV) administration was not associated with significantly increased adverse outcomes compared with no LAV exposure during the six-month follow-up period. Hospitalization occurred in 14.9% versus 15.3% of patients, respectively (risk ratio [RR] 0.97; 95% confidence interval [CI] 0.75\u20131.25; p = 0.819), while emergency department visits occurred in 12.6% vs 11.3% (RR 1.12; 95% CI 0.84\u20131.50; p = 0.450). There were no significant differences in fever (3.6% vs. 3.3%; RR 1.09; 95% CI 0.62\u20131.93; p = 0.764) or rash (4.0% vs. 2.7%; RR 1.50; 95% CI 0.83\u20132.70; p = 0.172). No cases of measles, mumps, rubella, varicella, yellow fever, or encephalitis were identified in either cohort during follow-up. Conclusions: LAVs were not associated with an increased risk of adverse outcomes within one day to six months among IBD patients receiving immunomodulatory therapy. These real-world findings suggest comparable short-term outcomes between the cohorts of patients with IBD receiving biologic or targeted synthetic therapy who met the predefined eligibility criteria including age \u2265 18 years, and vaccination occurring between two weeks and six months after biologic initiation regarding LAV use in patients with IBD receiving biologic agents.<\/jats:p>","DOI":"10.3390\/vaccines14060474","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:28:21Z","timestamp":1779802101000},"page":"474","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.3390","volume":"14","author":[{"given":"Niven","family":"Wang","sequence":"first","affiliation":[{"name":"Internal Medicine Department, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7761-8149","authenticated-orcid":false,"given":"Abdelrahman","family":"Yousef","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5689-026X","authenticated-orcid":false,"given":"Kevin","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Mok","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at Houston, Houston, TX 77054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2550-4837","authenticated-orcid":false,"given":"Mahmoud","family":"Yousef","sequence":"additional","affiliation":[{"name":"General Medicine Department, SUNY Upstate Medical University, Syracuse, NY 13210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Telbany","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-6961","authenticated-orcid":false,"given":"Abu Baker","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"},{"name":"Gastroenterology Department, Raymond G. Murphy Veterans Affairs Medical Center, Albuquerque, NM 87108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swathi","family":"Paleti","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, The University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","unstructured":"McDowell, C., Farooq, U., and Haseeb, M. (2026). Inflammatory Bowel Disease. StatPearls, StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s43556-025-00395-z","article-title":"Inflammatory bowel diseases: Pathological mechanisms and therapeutic perspectives","volume":"7","author":"Yang","year":"2026","journal-title":"Mol. 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Am."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/6\/474\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:43:49Z","timestamp":1779803029000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/6\/474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":20,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["vaccines14060474"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14060474","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}