title: Varicella vaccination in children with inflammatory bowel disease receiving immunosuppressive therapy.
abstract: Children with inflammatory bowel disease (IBD) are often receiving chronic immunosuppressive therapy to stay in clinical remission; however, these therapies also put patients at risk for infections. Therefore, it is important to immunize children to minimize vaccine-preventable infections. However, there is a paucity of data on immune response to vaccines in patients with IBD. Current guidelines recommend that patients with IBD receive inactivated vaccines but suggest against immunizing immunosuppressed patients having IBD with live vaccines such as varicella. Unfortunately, the recommendation to not vaccinate with varicella was not based on any data. We present a case series of children with IBD receiving immunosuppressive therapy who tolerated and had a good immune response to varicella vaccine. We also review the literature and demonstrate that studies in other immunocompromised populations suggest that varicella vaccine is generally well tolerated and immunogenic. We also argue that it is important to weigh the benefits against risks with individual patients having IBD to decide whether varicella vaccination should be considered. Additional studies evaluating the safety and immunogenicity of varicella vaccine in patients with IBD are needed.
authors.affiliation: Inflammatory Bowel Disease Center, Division of Gastroenterology, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
mesh_terms: D000293:Adolescent; D000328:Adult; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000276:immunology; D002648:Child; D000075202:Contraindications; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D055815:Young Adult
chemical_list: D019433:Chickenpox Vaccine; D007166:Immunosuppressive Agents