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Ulcerative Colitis Resource Center
August 14, 2015
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Meta-analysis shows no association between vaccination, IBD risk

Data from a recent meta-analysis showed there is no evidence of an association between vaccinations and risk for developing inflammatory bowel disease.

Whether vaccination has a causal link to IBD is controversial. Therefore, Laurent Peyrin-Biroulet, MD, PhD, from Nancy University Hospital in France, Guillaume Pineton de Chambrun, MD, PhD, from Lille University Hospital, and colleagues, performed a systematic review and meta-analysis of relevant literature published up to June 2014. Eight case-control and three cohort studies evaluating associations between childhood or adult vaccinations of any type, dose or vaccination schedule and subsequent development of IBD were included in the analysis.

Laurent Peyrin-Biroulet

Guillaume Pineton de Chambrun

“Because most of the studies analyzed the risk of developing IBD independently for each vaccine in the same patient population without reporting a global risk after vaccination, we performed the meta-analysis for each vaccine type separately,” the researchers wrote.

They found no association between developing IBD and childhood vaccinations, including:

  • Bacille Calmette-Guérin (RR = 1.04; 95% CI, 0.78-1.38) based on three case-control studies (n = 963);
  • diphtheria (RR = 1.24; 95% CI, 0.8-1.94) based on three case-control studies (n = 524);
  • tetanus (RR = 1.27; 95% CI, 0.77-2.08) based on three case-control studies (n = 524);
  • smallpox (RR = 1.08; 95% CI, 0.7-1.67) based on three case-control studies (n = 1,255);
  • poliomyelitis (RR = 1.79; 95% CI, 0.88-3.66) based on three case-control studies (n = 666); and
  • measles containing vaccines (in cohort studies, RR = 1.33; 95% CI, 0.31-5.8; in case-control studies, RR = 0.85; 95% CI, 0.6-1.2).

In subgroup analysis, the researchers did observe an association between the poliomyelitis vaccine and risk for developing Crohn’s disease (n = 345; RR = 2.28; 95% CI, 1.12-4.63) or ulcerative colitis (n = 174; RR = 3.48; 95% CI, 1.2-9.71). Only two case-control studies on pertussis vaccine were identified with conflicting results, so a meta-analysis was not performed. Only one cohort study on H1N1 vaccine (Pandemrix, GlaxoSmithKline) in adult patients showed a hazard ratio of 1.13 (95% CI, 0.97-1.32) for developing IBD.

“In conclusion, results of this meta-analysis do not support a role of childhood immunization or H1N1 vaccination in the development of IBD,” the researchers wrote. “The association between the poliomyelitis vaccine and risk for [Crohn’s disease] or [ulcerative colitis] should be analyzed cautiously because of study heterogeneity and will require further investigation.” – by Adam Leitenberger

Disclosure: The researchers report no relevant financial disclosures.

Sources/Disclosures

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Source: de Chambrun, et al. Clin Gastroenterol Hepatol. 2015;doi:10.1016/j.cgh.2015.04.179.