Immunosuppression and Vaccines
Vaccines take on added importance in UC because both the disease and its treatment, medications that suppress your immune system, make you more likely to get an infection. And Moss says illness is more concerning for UC patients than the general public. “Any infection that occurs in patients with UC can trigger flares, hospitalizations, and complications at a time when your body’s defenses are not operating at full strength,” he says.
Another layer of risk comes from infections that can stay in your body for years without causing symptoms, but may surface when your immune system is compromised, says Anish Sheth, MD, a gastroenterologist and the codirector of the Center for Digestive Health at Penn Medicine Princeton Health in Plainsboro, New Jersey.
“Many of these what we call latent infections, infections that you can harbor without manifesting signs or symptoms, can reactivate when the immune system is suppressed,” Dr. Sheth says, noting that patients are often screened for infections like hepatitis B before starting biologic therapy for this reason.
Disease activity, such as when you’re in a flare, also plays a role. “When you’re malnourished and you’ve lost weight and you’re on a medicine that’s going to suppress parts of your immune system, then the concern is that you’re going to have a more complicated, severe course of that infection if you do get sick,” Sheth says.
Some UC medications can also affect how well vaccines work. In certain cases, your immune system may mount a “blunted” response, one that’s not as strong as normal.
But that doesn’t mean vaccination isn’t worthwhile. “By taking the vaccine, you hope to prevent getting the infection to begin with, but then even if you do contract it, the hope is that the infection will be less severe than it otherwise would have been,” Sheth says.
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