Vaccines for Children under Paediatric Gastroenterology

You have been given this leaflet as your child has been started on a medication which may have an impact on how we give your child vaccines. This is because vaccines are available as either live or non-live (killed) vaccines. Live vaccines may be unsuitable if your child is taking immunosuppressive medication(s). Your child might need to avoid live vaccines unless advised by the paediatric gastroenterology team on an individual basis.

Children taking azathioprine, 6-mercaptopurine, sulfasalazine or mesalazine can receive live vaccinations.

Children on the following immunosuppressive medications should not have live vaccines:

• Biological therapies in the previous 12 months, e.g. infliximab, adalimumab, vedolizumab, ustekinumab, mirikizumab, risankizumab, guselkumab
• Small molecules in the previous 12 months e.g. upadacitinib, tofacitinib, etrasimod
• Steroids – prednisolone – until 3 months after finishing 20mg daily dose as part of reducing course.

This is because live vaccines can, in some cases, cause severe or fatal infections in immunosuppressed children due to extensive replication of the vaccine strain.

Additional information for children who should not have live vaccines:

• Your child should avoid entering the area where live nasal flu spray vaccines are being administered and stay in a different room temporarily (30 minutes after the administration of spray vaccines has ended) (e.g. at school).
• If you are sent a consent form from the school, please write on the form: ‘’NOT ALLOWED LIVE VACCINATIONS AS ON ... (Please state the name of the drug)’’
• Household contacts (aged six months and over) are likely to be eligible to receive the yearly flu vaccination – please speak to your family GP about this.
• Your child may need extra doses of some of the routine vaccinations to ensure they are effective e.g. HPV vaccine.

Travel advice

Vaccinations that are not part of the routine immunisation schedule may be required for patients travelling to areas where vaccine-preventable infections are present. Some travel vaccinations are live and therefore should not be given to patients who are on a biological therapy, or a small molecule medicine or steroid course.

Further advice

If you need any further advice please contact your GP, the Paediatric IBD Helpline (01223 274757), a Gastroenterology Consultant in Addenbrooke’s Hospital, Paediatric Gastroenterology Pharmacist (via switchboard) or the Medicines Information Department in Addenbrooke’s Hospital (via switchboard, ext 217502).