Key result
Live varicella vaccination triggers vaccine-strain varicella in 1 immunosuppressed Crohn's patient who fully recovers.
Why the study?
Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients.
Case Report (n=1)
Live vaccinations in patients on combination immunosuppression can lead to vaccine-strain viral infections, highlighting the need for clinical decision support systems to prevent inappropriate administration.
Potential risk warrants caution with live varicella in immunosuppressed Crohn's; case report leaves guidelines unchanged.
Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.
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Solano et al. (2025) conducted a case report in Crohn's disease (n=1). Live varicella vaccination was evaluated on Development of primary varicella (chickenpox) of a vaccine-viral strain. Live varicella vaccination in 1 patient with Crohn's disease on combination immunosuppression resulted in primary varicella of a vaccine-viral strain, from which she fully recovered.
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