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- Title
Immune Response to Influenza Vaccine in Children With Inflammatory Bowel Disease.
- Authors
Ying Lu; Jacobson, Denise L; Ashworth, Lori A; Grand, Richard J; Meyer, Anthony L; McNeal, Monica M; Gregas, Matt C; Burchett, Sandra K; Bousvaros, Athos
- Abstract
OBJECTIVES:Patients with inflammatory bowel disease (IBD) frequently receive immunosuppressive therapy. The immune response in these patients to vaccines has not been well studied. We conducted a prospective, open label study to evaluate the serologic response to influenza vaccine in children with IBD.METHODS:Serum was obtained from 146 children and young adults with IBD (96 Crohn's disease, 47 ulcerative colitis, and 3 indeterminate colitis) for baseline influenza titer, immediately followed by immunization with trivalent (A/Solomon Islands/3/2006 (H1N1), A/Wisconsin/67/2005 (H3N2), and B/Malaysia/2506/2004 (B)) inactivated influenza vaccine. Patients returned for repeat titers 3–9 weeks later. Seroprotection against each influenza strain was defined as hemagglutination inhibition titer ≥40. Patients were categorized as nonimmunosuppressed (NIS; aminosalicylates only, antibiotics only, or no therapy) or immunosuppressed (IS; any immunosuppressive agent). IS patients were further subcategorized as: (i) tacrolimus, (ii) tumor necrosis factor-α (TNF-α) inhibitor, (3) immunomodulator, and (4) corticosteroids only.RESULTS:More patients were seroprotected against strains A/H1N1 and A/H3N2 than B strain (P<0.02), regardless of immunosuppression status. The proportion of seroprotected patients and geometric mean titers at post-vaccination were similar between NIS and IS groups for all three strains. Subanalysis of patients not seroprotected at baseline showed that those receiving anti-TNF therapy were less likely to be seroprotected against strain B (14%) compared to patients in the NIS group (39%, P=0.025). There were no serious vaccine-associated adverse events.CONCLUSIONS:Influenza vaccination produces a high prevalence of seroprotection in IBD patients, particularly against A strains. The vaccine is well tolerated. Routine influenza vaccination in IBD patients is recommended, irrespective of whether patients receive immunosuppressive medications.Am J Gastroenterol 2009; 104:444–453; doi:10.1038/ajg.2008.120; published online 27 January 2009
- Subjects
INFLUENZA vaccines; INFLAMMATORY bowel diseases; JUVENILE diseases; IMMUNE response; IMMUNOSUPPRESSIVE agents
- Publication
American Journal of Gastroenterology (Springer Nature), 2009, Vol 104, Issue 2, p444
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1038/ajg.2008.120