IBD Alert: Are You Getting the Right Protection Against Infections?
"New research reveals gaps in opportunistic infection prevention for IBD patients on biologics – and how to close them."
If you're managing inflammatory bowel disease (IBD) with biological agents like anti-TNF therapies, you're likely focused on controlling inflammation and improving your quality of life. But there's another critical aspect of your care that deserves attention: protecting yourself from opportunistic infections.
A concerning study presented at the British Society of Gastroenterology (BSG) 2014 meeting reveals significant gaps in the prevention of these infections in IBD patients on biological agents. The research highlights that many patients aren't receiving the recommended vaccinations, leaving them vulnerable to preventable illnesses.
This article dives into the study's findings and what they mean for you. You'll learn about the specific infections you should be aware of, the recommended preventative measures, and how to advocate for your health with your healthcare provider. Stay informed and empowered to protect yourself while managing your IBD.
IBD and Infection Prevention
The CDC reports that IBD prevalence is rising in the United States and describes IBD as a group of lifelong diseases, including ulcerative colitis and Crohn’s disease. A review assessed published literature on prophylactic screening and vaccination options for people with IBD from 1980 to 2020. It reports that during the COVID-19 pandemic, most publications included vaccination recommendations or guidelines, while only 38% included real-world data assessing reactions to vaccination.
Vaccination and Preventive Care
Immunosuppressive therapies commonly used for IBD increase susceptibility to infectious pathogens, and appropriate vaccination can prevent some infections. Although vaccination schedules for people with IBD have been published, vaccination rates remain inadequate. On May 6, 2025, the American Gastroenterological Association released a clinical practice update with recommendations about vaccinations and non-colorectal cancer screenings for people with IBD.
The Vaccination Gap: What the Research Shows
The study, conducted at Chelsea and Westminster Hospital in London, audited the preventative measures taken against opportunistic infections in IBD patients prescribed anti-TNF therapies. Researchers compared these measures to the European Crohn's and Colitis Organisation (ECCO) guidelines, which recommend several key vaccinations:
- Influenza (annual)
- Pneumococcal
- Hepatitis B
- Varicella (chickenpox)
- HPV (for women under 26)
Sun Protection Guidance
The ACG 2025 preventive-care guideline summary advises counseling patients about sun protection when starting immunosuppressive therapy for IBD. It specifies sunscreen that protects against both ultraviolet A and ultraviolet B light, along with protective clothing. The recommendation is presented as part of preventive care accompanying immunosuppressive treatment.
Vaccines and Travel Precautions
A 2021 systematic review states that people with IBD are at risk of infections, many of which are preventable with vaccination. The European Crohn’s and Colitis Organisation (ECCO) consensus on opportunistic infections brought together 30 IBD and infectious disease specialists. ECCO’s 2026 guideline recommends pre-travel counseling, preferably at a specialized travel clinic, to review infection-prevention measures, vaccination plans, live-vaccine contraindications during immunosuppression, potentially reduced responses to prior inactivated vaccines, and possible drug interactions.
Taking Control of Your Infection Prevention
The research is a wake-up call to improve how we protect IBD patients on biological agents from opportunistic infections. Don't wait for your healthcare provider to bring it up—take the initiative and start the conversation.
Prevention as a Future Priority
A November 2025 article describes a shift in IBD research toward prevention and highlights the “3 Ps”: prevention, pre-diagnosis, and prediction. A 2024 article points to rising IBD incidence in rapidly modernizing areas as a reason to investigate environmental triggers. It raises the possibility of modifying environmental exposures that promote inflammation or monitoring people at higher risk, such as first-degree relatives of patients with IBD. These are presented as future directions, not established prevention strategies.
Here are some actionable steps you can take:
By taking a proactive approach to infection prevention, you can minimize your risk and focus on managing your IBD effectively. Stay informed, advocate for yourself, and work with your healthcare team to create a comprehensive plan that addresses all aspects of your care.