The American Gastroenterological Association updated its clinical practice recommendations regarding vaccinations and non-colorectal cancer screenings for people with inflammatory bowel disease.
Freddy Caldera, DO, a gastroenterologist at UW Health in Madison, Wis., said in a May 6 AGA news release that there will likely be updates to the information as evidence develops related to vaccination strategies and non-colorectal cancer screening.
The update includes 13 best-practice statements for treating patients with IBD:
1. All adult patients with IBD should receive age-appropriate cancer screening.
2. All adult women with IBD should receive age-appropriate screening for cervical dysplasia.
3. All adult patients with IBD should follow skin cancer primary prevention practices.
4. A thorough anal and perianal examination should be performed at every colonoscopy.
5. Patients with IBD should follow the CDC’s vaccination schedule but should avoid live vaccines. GI clinicians should discuss vaccination with their patients, sharing responsibility for administration with the patient’s primary care provider.
6. Inactivated vaccines are safe in patients with IBD and are not associated with IBD exacerbation.
7. All adult patients with IBD should be evaluated for latent hepatitis B infection. Patients who are not seroprotected should receive a challenge dose and be reevaluated four to eight weeks later. If no amnestic response is observed, the patient should receive the full hepatitis B series.
8. All adult patients with IBD should receive an annual inactivated influenza vaccine.
9. Patients with IBD who are ages 19 to 64 should receive an initial pneumococcal vaccine and a subsequent second dose at age 65.
10. Patients with IBD age 60 or older should receive a respiratory syncytial virus vaccine.
11. All patients with IBD age 19 and older on immune-modifying therapy or with plans to initiate immune-modifying therapy should receive a recombinant herpes zoster vaccine series, regardless of prior varicella vaccination status.
12. Bone densitometry should be considered in patients with IBD regardless of age when risk factors for osteopenia and osteoporosis are present.
13. Adult patients with IBD should be screened annually for depression and anxiety, and patients who screen positive should be referred to the appropriate specialist.
Related to vaccines specifically, Dr. Caldera said “patients with IBD should trust their gastroenterologist,” underscoring the need to educate patients about the data supporting vaccination.
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