Noa Krugliak Cleveland, MD
Noa Krugliak Cleveland, MD

Poster 1039 Many IBD Patients Are Not Immune to Measles and Pertussis

Author Insight from Noa Krugliak Cleveland, MD, University of Chicago Medicine

What’s new here and important for clinicians?

It is well-known that patients with inflammatory bowel disease (IBD) receiving immunosuppressive (ISS) treatments are at an increased risk for a number of vaccine-preventable infections such as influenza, pneumococcal pneumonia, and zoster. Additionally, we know that the immune response to vaccinations is reduced in IBD patients who are on ISS therapy, and current CDC and IBD guidelines indicate that live vaccinations are contraindicated in these patients.

Given the recent resurgence of measles as well as pertussis (whooping cough) infections, we assessed the immune status of our IBD population at the University of Chicago Inflammatory Bowel Disease Center in order to advise about these risks.

We found that a significant number of our IBD patients lack immunity to measles and the majority of our IBD patients do not have detectable immunity to pertussis. Patients with disease durations of longer than 10 years and patients 50 years and older had significantly lower immunity (titer levels) to these infections. We also found that many of the non-immune patients were women of childbearing age, putting them at risk of these infections during pregnancy, as well as patients who are receiving ISS and are therefore unable to receive the booster.

Our findings emphasize that clinicians need to be aware of the risk of these infections as well as their patients’ immune status in order to provide recommendations for management, protection and counseling.  Additionally, knowing the immune status for measles is especially important prior to initiation of ISS therapy, as the measles, mumps and rubella (MMR) vaccine is a live vaccine that can only be administered prior to initiation of such therapy.

What do patients need to know?

IBD patients receiving ISS should be aware of their increased risk for vaccine preventable infections such as influenza, pneumococcal pneumonia, and shingles, as well as measles and pertussis. They should be proactive about being up to date with their vaccinations and ask their physician to check their immune status for measles and pertussis. We also encourage patients to discuss with their gastroenterologist any additional vaccinations they should receive prior to initiation of ISS or immunomodulation therapy.

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Author Contact Noa Krugliak Cleveland, MD, University of Chicago Medicine

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