Vaccines and UC
Vaccine administration is a complex process with varying schedules. Since people move around so much today these vaccinations are often administered by multiple health care providers, so full records are often lacking. More people than ever are traveling to exotic locales which require special vaccination.
Vaccine administration in the immunocompromised patient can have severe consequences. A UC patient is considered immunocompromised if she has:
1) significant malnutrition OR is currently on or has received any of the following UC treatments within the past 3 months:
2) azathioprine,
3) 6-mercaptopurine
4) infliximab
5) >20mg/day prednisone
If you meet the criteria for immunocompromise the the following live bacterial and viral vaccines should be avoided since they may cause active.
Varicella
Zoster
MMR (measles, mumps, rubella)
BCG
Anthrax
Smallpox
Yellow fever
Adenovirus
Typhoid
Cholera
Tick-borne encephalitis
According to the US Centers for Disease Control (CDC) immunocompromised UC patients should receive immunizations for tetanus, diphtheria, pertussis, influenza and pneumococcus according to the same schedule as the general population. Young women can and should receive the new HPV vaccine. The Hepatitis A and B and meningococcal vaccines should be given as needed for travel or based upon expected exposure.
Travel to certain areas of the world, such as Africa, which requires a yellow fever vaccine, is contraindicated while immunocompromised. When it becomes apparent that you will be starting immunosuppression, it is important to discuss whether any of the live vaccines need to be administered prior to initiation to therapy. For example, a patient who has not ever had chicken pox would want to have the varicella vaccine prior to immunosuppression to avoid complications later on.
For more information see the CDC website at www.cdc.gov.