Background: Inflammatory bowel disease (IBD) patients with immunocompromise have a high risk of developing complications related to viral infections. Western countries were the first to formulate vaccine guideline. Asian countries developed their national and international vaccine guidelines a little later in order to reduce the risk of mortality from viral infections. However, no studies to date have examined the differences in vaccinations that prevail among Asian countries. Summary: This review summarizes the vaccination status and schedules in various Asian countries for immunocompromised IBD patients. Vaccination rates, regardless of the specific vaccine, were high in Japan, South Korea, and China and low in India and the Philippines. Vaccine schedules differed by country, and outbreaks of measles and rubella were seen due to low vaccination rates in Southeast Asia and South Asia. Live vaccines cannot be administered during immunosuppressive treatment. Infection with measles, mumps, and varicella during immunosuppressive therapy carries a high risk of mortality, and thus confirmation of immunization status is recommended as soon as IBD is diagnosed and, when possible, live vaccines should be administered before the initiation of immunosuppressive treatment. In patients seronegative for hepatitis B, administration of the hepatitis B vaccine is also recommended. Key Messages: Physicians, while considering severity of outbreaks, should understand the differences in vaccination status that exist among the various Asian countries and regions.

Keywords:
Immunization coverage, Immunocompromise, Inflammatory bowel disease, Live vaccine, Vaccination
1.
Gisbert JP, Chaparro M: Vaccination strategies in patients with IBD. Nat Rev Gastroenterol Hepatol 2013; 10: 277–285.
2.
Reich J, Wasan S, Farraye FA: Vaccinating patients with inflammatory bowel disease. Gastroenterol Hepatol 2016; 12: 540–546.
3.
Desalermos AP, Farraye FA, Wasan SK: Vaccinating the inflammatory bowel disease patient. Expert Rev Gastroenterol Hepatol 2015; 9: 91–102.
4.
Naganuma M, Nagahori M, Fujii T, Morio J, Saito E, Watanabe M: Poor recall of prior exposure to varicella zoster, rubella, measles, or mumps in patients with IBD. Inflamm Bowel Dis 2013; 19: 418–422.
5.
Okabe N, Arakawa S, Iwata S, Okabe, Ihara T, Shiraishi T, Taya K, Fujimoto T, Mikamo H, Yasuoka A: Vaccine guidelines for medical personnel. Jpn J Infect Prev Control 2014; 29(suppl 3):S1–S14.
6.
Byrne L, Brant L, Reynolds C, Ramsay M: Seroprevalence of low rubella IgG antibody levels among antenatal women in England tested by NHS blood and transplant: 2004–2009. Is rubella susceptibility increasing? Vaccine 2012; 30: 161–167.
7.
Kang HJ, Han YW, Kim SJ, Kim YJ, Kim AR, Kim JA, Jung HD, Eom HE, Park O, Kim SS: An increasing, potentially measles-susceptible population over time after vaccination in Korea. Vaccine 2017; 35: 4126–4132.
8.
Lao TT, Sahota DS, Law LW, Leung TY: Rubella seronegativity in antenatal screening – is it influenced by the introduction of universal childhood rubella immunization? Vaccine 2015; 33: 4776–4781.
9.
Mou J, Griffiths SM, Fong HF, Hu Q, Xie X, He Y, Ma H, Cheng J: Seroprevalence of rubella in female migrant factory workers in Shenzhen, China. Vaccine 2010; 28: 7844–7851.
10.
Lopez AL, Raguindin PF, Silvestre MA, Fabay XC, Vinarao AB, Manalastas R: Rubella and congenital rubella syndrome in the Philippines: a systematic review. Int J Pediatr 2016; 2016: 8158712.
11.
Arunkumar G, Vandana KE, Sathiakumar N: Prevalence of measles, mumps, rubella, and varicella susceptibility among health science students in a University in India. Am J Ind Med 2013; 56: 58–64.
12.
Lu Y, Bousvaros A: Immunizations in children with inflammatory bowel disease treated with immunosuppressive therapy. Gastroenterol Hepatol 2014; 10: 355–363.
13.
Takeshige A, Yamaguchi M, Iwata S, Maezawa K, Kizu J: Determination of antibody titers and vaccination against epidemic viral infections in medical professionals. Jpn J Environ Infect 2014; 29: 23–31.
14.
Rafat C, Klouche K, Ricard JD, Messika J, Roch A, Machado S, Sonneville R, Guisset O, Pujol W, Guérin C, Teboul JL, Mrozek N, Darmon M, Chemouni F, Schmidt M, Mercier E, Dreyfuss D, Gaudry S: Severe measles infection: The spectrum of disease in 36 critically ill adult patients. Medicine (Baltimore) 2013; 92: 257–272.
15.
Kaplan LJ, Daum RS, Smaron M, McCarthy CA: Severe measles in immunocompromised patients. JAMA 1992; 267: 1237–1241.
16.
Gray MM, Hann IM, Glass S, Eden OB, Jones PM, Stevens RF: Mortality and morbidity caused by measles in children with malignant disease attending four major treatment centres: a retrospective review. Br Med J (Clin Res Ed) 1987; 295: 19–22.
17.
Kernahan J, McQuillin J, Craft AW: Measles in children who have malignant disease. Br Med J (Clin Res Ed) 1987; 295: 15–18.
18.
Young MK, Nimmo GR, Cripps AW, Jones MA: Post-exposure passive immunisation for preventing measles. Cochrane Database Syst Rev 2014; 4:Cd010056.
19.
Wichmann A, Krugliak Cleveland N, Rubin DT: Safety and efficacy of live measles vaccine administered to a Crohn’s disease patient receiving vedolizumab. Am J Gastroenterol 2016; 111: 577.
20.
Takahashi E, Kurosaka D, Yoshida K, Yanagimachi M, Kingetsu I, Yamada A: Onset of modified measles after etanercept treatment in rheumatoid arthritis. Jpn J Clin Immunol 2010; 33: 37–41.
21.
Bernstein CN, Rawsthorne P, Blanchard JF: Population-based case-control study of measles, mumps, and rubella and inflammatory bowel disease. Inflamm Bowel Dis 2007; 13: 759–762.
22.
Kimura T, Tsunekawa K, Ogiwara T, Tokue Y, Nara, M, Inoue T, Obuchi T, Suto C, Ohshima K, Murakami M: Seroprevalence of measles- and mumps-specific immunoglobulin G among Japanese healthcare students increased during 2007–2012. Jpn J Infect Dis 2013; 66: 411–415.
23.
Bakshi N, Lawson J, Hanson R, Ames C, Vinters HV: Fatal mumps meningoencephalitis in a child with severe combined immunodeficiency after bone marrow transplantation. J Child Neurol 1996; 11: 159–162.
24.
Eyre TA, Pelosi E, McQuaid S, Richardson D, Newman J, Hill K, Veys P, Davies G, Orchard KH: Mumps virus encephalomyelitis in a 19-year old male patient with an undefined severe combined immunodeficiency post-haematopoietic bone marrow transplantation: a rare fatal complication. J Clin Virol 2013; 57: 165–168.
25.
Sugishita Y, Akiba T, Sumitomo M, Hayata N, Hasegawa M, Tsunoda T, Okazaki T, Murauchi K, Hayashi Y, Kai A, Seki N, Kayebeta A, Iwashita Y, Kurita M, Tahara N: Shedding of rubella virus among infants with congenital rubella syndrome born in Tokyo, Japan, 2013–2014. Jpn J Infect Dis 2016; 69: 418–423.
26.
Geiger R, Fink FM, Solder B, Sailer M, Enders G: Persistent rubella infection after erroneous vaccination in an immunocompromised patient with acute lymphoblastic leukemia in remission. J Med Virol 1995; 47: 442–444.
27.
Prelog M. Differential approaches for vaccination from childhood to old age. Gerontology. 2013; 59: 230–239.
28.
Cullen G, Baden RP, Cheifetz AS: Varicella zoster virus infection in inflammatory bowel disease. Inflamm Bowel Dis 2012; 18: 2392–2403.
29.
Leung VS, Nguyen MT, Bush TM: Disseminated primary varicella after initiation of infliximab for Crohn’s disease. Am J Gastroenterol 2004; 99: 2503–2504.
30.
Maillot C, Riachi G, Francois A, Ducrotte P, Lerebours E, Hemet J, Colin R: Digestive manifestations in an immunocompetent adult with varicella. Am J Gastroenterol 1997; 92: 1361–1363.
31.
Marehbian J, Arrighi HM, Hass S, Tian H, Sandborn WJ: Adverse events associated with common therapy regimens for moderate-to-severe Crohn’s disease. Am J Gastroenterol 2009; 104: 2524–2533.
32.
Gupta G, Lautenbach E, Lewis JD: Incidence and risk factors for herpes zoster among patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2006; 4: 1483–1490.
33.
Winthrop KL, Yamanaka H, Valdez H, Mortensen E, Chew R, Krishnaswami S, Kawabata T, Riese R: Herpes zoster and tofacitinib therapy in patients with rheumatoid arthritis. Arthritis Rheumatol 2014; 66: 2675–2684.
34.
Khan N, Shah Y, Trivedi C, Lewis JD: Safety of herpes zoster vaccination among inflammatory bowel disease patients being treated with anti-TNF medications. Aliment Pharmacol Ther 2017; 46: 668–672.
35.
World Health Organization: Global tuberculosis report 2016. Geneva, World Health Organization, 2016.
36.
Rodrigues LC, Diwan VK, Wheeler JG: Protective effect of BCG against tuberculous meningitis and miliary tuberculosis: a meta-analysis. Int J Epidemiol 1993; 22: 1154–1158.
37.
Toussirot E, Wendling D. Bacillus calmette-guerin vaccination in a patient treated with infliximab. J Rheumatol 2005; 32: 2500–2501.
38.
Cheent K, Nolan J, Shariq S, Kiho L, Pal A, Arnold J: Case report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn’s disease. J Crohns Colitis 2010; 4: 603–605.
39.
Tokuda H, Harigai M, Kameda H, Tomono K, Takayanagi N, Watanabe A, Tasaka S, Suda T, Tateda K, Kadota J: Consensus statements for medical practice: Biological agents and lung disease [Abridged English translation by the Japanese Respiratory Society]. Respir Investig 2017; 55: 229–251.
40.
Papay P, Primas C, Eser A, Novacek G,Winkler S, Frantal S, Angelberger S, Mikulits A, Dejaco C, Kazemi-Shirazi L, Vogelsang H, Reinisch W: Retesting for latent tuberculosis in patients with inflammatory bowel disease treated with TNF-alpha inhibitors. Aliment Pharmacol Ther 2012; 36: 858–865.
41.
Jauregui-Amezaga A, Turon F, Ordas I, Gallego M, Feu F, Ricart E, Panes J: Risk of developing tuberculosis under anti-TNF treatment despite latent infection screening. J Crohns Colitis 2013; 7: 208–212.
42.
Debeuckelaere C, De Munter P, Van Bleyenbergh P, De Wever W, Van Assche G, Rutgeerts P, Vermeire S: Tuberculosis infection following anti-TNF therapy in inflammatory bowel disease, despite negative screening. J Crohns Colitis 2014; 8: 550–557.
43.
World Health Organization: Hepatitis B, 2017. http://www.who.int/mediacentre/factsheets/fs204/en/ (accessed October 1, 2017).
44.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ: Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 2015; 386: 1546–1555.
45.
World Health Organization: Immunization Coverage, 2017. http://www.who.int/mediacentre/factsheets/fs378/en/ (accessed October 1, 2017).
46.
Hsu HM, Lu CF, Lee SC, Lin SR, Chen DS: Seroepidemiologic survey for hepatitis B virus infection in Taiwan: the effect of hepatitis B mass immunization. J Infect Dis 1999; 179: 367–370.
47.
Xiao J, Zhang J, Wu C, Shao X, Peng G, Peng Z, Ma W, Zhang Y, Zheng H: Impact of hepatitis B vaccination among children in Guangdong Province, China. Int J Infect Dis 2012; 16:e692–e696.
48.
Zuckerman J, van Hattum J, Cafferkey M, Gjørup I, Hoel T, Rummukainen ML, Weiland O: Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe? Lancet Infect Dis 2007; 7: 410–419.
49.
National Institute of Infectious Diseases. Acute hepatitis B, April 2006-December 2015. IASR 2016; 37: 147–148. http://www.niid.go.jp/niid/en/iasr-vol33-e/865-iasr/6692-438te.html (accessed April 22, 2018).
50.
Ikeda M, Yamamoto H, Kaneko M, Oshima, H, Takahashi H, Umemoto K, Watanabe K, Hashimoto Y, Ohno I, Mitsunaga S, Okusaka T: Screening rate for hepatitis B virus infection in patients undergoing chemotherapy in Japan. Int J Cin Oncol 2016; 21: 1162–1166.
51.
Chang MH, You SL, Chen CJ, Liu CJ, Lee CM, Lin SM, Chu HC, Wu TC, Yang SS, Kuo HS, Chen DS: Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: A 20-year follow-up study. J Natl Cancer Inst 2009; 101: 1348–1355.
52.
Japanese encephalitis: Surveillance and immunization in Asia and the Western Pacific, 2016. Wkly Epidemiol Rec 2017; 92: 323–331.
53.
Wasan SK, Baker SE, Skolnik PR, Farraye FA: A practical guide to vaccinating the inflammatory bowel disease patient. Am J Gastroenterol 2010; 105: 1231–1238.
54.
Manthiram K, Blood EA, Kuppuswamy V, Martins Y, Narayan A, Burmeister K, Parvathy K, Hassan A: Predictors of optional immunization uptake in an urban south Indian population. Vaccine 2014; 32: 3417–3423.
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