Dr. Elizabeth Squirell · Gastroenterologist · Kingston Health Sciences Centre

Vaccines and IBD

Which vaccines you need with Crohn's or colitis, which are safe on immune-weakening medicines, and why timing matters for live vaccines.

Key points

Ask your IBD team to check your vaccines when you are diagnosed, and before you start any new IBD medicine.
Get the flu shot every fall and stay up to date with COVID-19 vaccines. Choose the shot, not the nasal spray.
On immune-weakening medicines, you need one dose of a newer pneumonia vaccine (Prevnar 20 or Capvaxive) and two doses of the shingles vaccine Shingrix.
Non-live vaccines are safe on all IBD medicines. They may work a little less well, but they still protect you.
Do not get live vaccines (MMR, chickenpox, yellow fever, oral typhoid, nasal flu) while on immune-weakening medicines.
If you may need a live vaccine, get it at least 4 weeks before starting an immune-weakening medicine.
Make sure you are immune to measles before you start. If you are near someone with measles, call your doctor the same day.
Planning a trip? See a travel clinic well before you go and tell them about your IBD medicines.
If you took a biologic in pregnancy, tell your baby's doctor before any vaccines.

Trouble breathing, or swelling of your face, lips or throat after a vaccine
Hives all over your body, or you feel faint after a vaccine
A high fever and you feel very unwell while on immune-weakening medicine
Severe belly pain, heavy bleeding from your bottom, or vomiting that will not stop