Vaccines (Basel). 2021 May 11;9(5):487. doi: 10.3390/vaccines9050487.

Susanna Esposito ¹, Giulia Antoniol ¹, Marialuisa Labate ¹, Lucrezia Passadore ¹, Patrizia Alvisi ², Valeria Daccò ³, Chiara Ghizzi ⁴, Carla Colombo ³, Nicola Principi ⁵

Author information

• ¹Paediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
• ²Pediatric Gastroenterology Unit, Maggiore Hospital, 40133 Bologna, Italy.
• ³Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy.
• ⁴Pediatric Unit, Maggiore Hospital, 40133 Bologna, Italy.
• ⁵Università degli Studi di Milano, 20122 Milan, Italy.

Abstract

Incidence of inflammatory bowel diseases (IBDs), including Crohn's disease (CD) and ulcerative colitis (UC), is increasing worldwide. Children with IBDs have a dysfunctional immune system and they are frequently treated with immunomodulating drugs and biological therapy, which significantly impair immune system functions and lead to an increased risk of infections. Vaccines are essential to prevent at least part of these infections and this explains why strict compliance to the immunization guidelines specifically prepared for IBD patients is strongly recommended. However, several factors might lead to insufficient immunization. In this paper, present knowledge on the use of vaccines in children with IBDs is discussed. Literature review showed that despite a lack of detailed quantification of the risk of infections in children with IBDs, these children might have infections more frequently than age-matched healthy subjects, and at least in some cases, these infections might be even more severe. Fortunately, most of these infections could be prevented when recommended schedules of immunization are carefully followed. Vaccines given to children with IBDs generally have adequate immunogenicity and safety. Attention must be paid to live attenuated vaccines that can be administered only to children without or with mild immune system function impairment. Vaccination of their caregivers is also recommended. Unfortunately, compliance to these recommendations is generally low and multidisciplinary educational programs to improve vaccination coverage must be planned, in order to protect children with IBD from vaccine-preventable diseases.