Review early
Check vaccine records at IBD diagnosis, before a treatment change, and during routine preventive-care visits.
Therapy first. Vaccine plan second.
Make vaccine planning easier for adults with IBD.
Select the patient's current or planned therapy. The page summarizes which vaccines are generally safe, which live vaccines require special timing, and what to review before immune-modifying treatment.
- Adult, U.S.-focused
- Runs in the browser
- No patient data stored
Start here
Three golden rules
Vaccinate before therapy when feasible
Needed live vaccines generally require at least 4 weeks before immunosuppression. Non-live vaccines work best when given before treatment, but urgent IBD care should not be delayed.
Use non-live vaccines during therapy
Most routine vaccines remain safe. Immune response may be lower with corticosteroids, anti-TNF combination therapy, JAK inhibitors, and some other agents.
Interactive therapy selector
Build a vaccine discussion plan
This is a screening and counseling aid, not a vaccine order set. It does not know the patient's complete vaccine history or contraindications.
Priority review
Vaccines and actions to discuss
Therapy-specific
What the selected therapy changes
Before treatment
Clinic checklist
Final clinical check: confirm prior vaccine products and dates, disease activity, medication dose/timing, pregnancy, severe allergies, prior adverse reactions, acute illness, and current CDC/ACIP guidance. Complex pneumococcal histories should be checked with CDC PneumoRecs or the current schedule notes.
Universal adult IBD reference
Vaccine-by-vaccine quick table
Use this table after reviewing the medication-specific plan. “Safe during therapy” does not guarantee a normal immune response.
| Vaccine | Who to review | During immune-modifying therapy | Key timing / clinic note |
|---|---|---|---|
| InfluenzaInjection, recombinant, or adjuvanted | All adults, every season | Safe | Avoid the live intranasal vaccine. Adults 65+ should receive a high-dose, recombinant, or adjuvanted product; AGA notes possible benefit from high-dose vaccine with anti-TNF monotherapy. |
| COVID-19Current-season product | Individual-based decision-making; benefit is greatest for higher-risk patients | Safe | Moderately or severely immunocompromised patients use a modified schedule. Do not delay vaccination solely because the patient is receiving immunosuppressive therapy. |
| PneumococcalPCV15, PCV20, or PCV21 pathways | All adults 50+; adults 19–49 with qualifying risk such as iatrogenic immunosuppression | Safe | If no prior PCV, use PCV20/PCV21 alone or PCV15 followed by PPSV23. Prior-dose histories require schedule-specific review. AGA 2025 recommends broader initial vaccination for all adults with IBD ages 19–64. |
| Recombinant zosterShingrix; non-live | All adults 50+; adults 19+ who are or will be immunosuppressed | Safe | Two doses. Usually 2–6 months apart; shorten to 1–2 months when faster completion would avoid more intense immunosuppression. |
| Hepatitis BRecombinant | All adults 19–59; adults 60+ with risk or seeking protection; all adult IBD patients should be evaluated for latent HBV | Safe | Use the HBsAg, anti-HBs, total anti-HBc triple panel when not previously screened. Vaccination should not be withheld while awaiting testing when indicated. |
| RSVSingle dose; not annual at present | All adults 75+; adults 50–74 at increased risk, including moderate/severe immune compromise | Safe | Best given before the local RSV season. AGA 2025 recommended RSV vaccination for all adults with IBD 60+; current CDC eligibility is age- and risk-based as shown here. |
| HPVGardasil 9 | Catch-up through age 26; shared decision-making ages 27–45 | Safe | Three-dose schedule for people who start at age 15+ and for immunocompromised patients. Not routinely recommended after age 45. |
| Tdap / TdTetanus, diphtheria, pertussis | All adults | Safe | One Tdap if never received as an adult, then Td or Tdap every 10 years; Tdap during each pregnancy. |
| Hepatitis AInactivated | Risk-based, travel-related, chronic liver disease, or anyone requesting protection | Safe | Review travel, liver disease, exposure, occupation, housing, and other ACIP indications. |
| MMRLive | Adults without acceptable evidence of immunity when otherwise eligible | Avoid | Give at least 4 weeks before immunosuppression. Do not give during pregnancy or clinically significant immunosuppression. |
| VaricellaLive; not Shingrix | Adults without evidence of immunity when otherwise eligible | Avoid | Two-dose live series when indicated, completed before immunosuppression. Shingrix does not establish varicella immunity and does not replace varicella vaccine. |
| Travel / other live vaccinesYellow fever, oral typhoid, dengue, others | Only when destination, exposure, or other risk indicates | Specialist review | Refer early to travel medicine or infectious diseases. A non-live alternative may be available for some diseases, such as injectable typhoid vaccine. |
No vaccine rows match that search.
Before a biologic, small molecule, or prolonged systemic steroid
Pair vaccination with a pre-treatment safety checklist.
Vaccination is one part of treatment readiness. The uploaded OpenEvidence material also highlights infection screening and immune-status review before advanced therapy.
Do not confuse screening with vaccination.
TB, hepatitis B/C, HIV, and other tests help identify latent infection or treatment risk. They do not substitute for checking vaccine records.
Reconcile records
Review EHR, state registry, pharmacy, prior health system, and patient documentation. Record dates and products, not only “up to date.”
Screen for hepatitis B
Obtain HBsAg, anti-HBs, and total anti-HBc when not previously screened. Vaccinate susceptible patients and refer active or prior infection for an HBV reactivation plan.
Catch up vaccines
Complete needed live vaccines at least 4 weeks before immunosuppression. Give non-live vaccines preferably at least 2 weeks before when feasible, without delaying urgent IBD therapy.
Complete treatment-specific screening
Use the drug label and clinic protocol for TB, hepatitis C, HIV, VZV/MMR history, pregnancy, CBC/chemistry, and other therapy-specific testing.
Evidence and governance
Built for transparent clinical review.
The reference page separates sources supplied in the OpenEvidence documents from current CDC sources added during review. It also identifies recommendations that changed or differ between specialty guidance and the current U.S. immunization schedule.