Getting a Flu Shot While Taking Immunosuppressants

People with inflammatory bowel disease (IBD) may be at an increased risk for complications from the flu (influenza). That's because IBD affects the immune system, and medications used to treat IBD—like Humira—weaken the immune system.

For many people, the flu is a manageable illness, but for people who are immunocompromised, it can be serious. According to the Centers for Disease Control and Prevention (CDC), deaths from the flu vary widely every year because of the variation in flu seasons. Since 1976, flu death totals in the US have ranged from 3,000 and 49,000 a year. Most of the fatalities are people over the age of 65.

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Complications From the Flu

The flu can lead to complications, which can be life threatening.

Common complications from the flu can include:

  • Bronchitis: Bronchitis is an infection of the bronchial tubes (airway) that can cause a cough, wheezing and fatigue. It may go away on its own in a few weeks, but it might also need treatment to resolve, especially if it's caused by a bacteria that can be treated with antibiotics.
  • Ear infections: An infection inside the ear, which is also called otitis media, can occur as a complication of the flu. Some of the symptoms include fever, ear pain, and dizziness or balance problems. 
  • Pneumonia: Pneumonia is a lung infection that can occur after a cold or the flu. It can cause pain when breathing, cough with sputum, and fever. Pneumonia can be especially dangerous for the very young and the very old.
  • Sinus infections (sinusitis): The sinuses, which are located around the eyes, can commonly become infected along with the flu or after the flu. Sinusitis can cause a headache or facial pain, fever, and sinus congestion. A sinus infection may need treatment, or it may resolve on its own. 

IBD Drugs That Are Immunosuppressants

Because IBD is an immune-mediated condition, medications that suppress the immune system are sometimes given as a treatment. This is thought to keep the inflammation from IBD in check. However, this also means that the body is less able to fight off infections, such as those that are caused by bacteria or viruses, including the flu (which is a virus).

Immunosuppressive drugs are commonly used to treat IBD, and people taking these types of medications are considered to be at higher risk for developing complications from the flu.

There are a few categories of medications for IBD that may have immunosuppressant effects; immunomodulators, steroids, biologics, and small molecules.

Some immunomodulator drugs include:

Some corticosteroid medications include:

  • Prednisone

Some biologics include:

Some small molecules include:

When to Get a Flu Shot

Since the timing of the onset, peak, and end of flu season changes from year to year and cannot be predicted, it is difficult to pinpoint the best time for getting vaccinated.

For people taking medications that suppress the immune system, the optimum time to receive a flu shot is from October to mid-November.

Flu shots are generally available in early September. The flu shot should be scheduled well before the flu season starts because it can take one to two weeks for the shot to take effect.

Flu activity usually peaks between December and February, with some activity as late as May. Therefore, you can have your vaccination later, if necessary, because receiving a shot late is better than not getting one at all.

IBD drugs should not prevent someone with Crohn's disease or ulcerative colitis from getting the flu shot.

Differences Between Shot and Nasal Vaccine

The inactivated flu shot contains dead viruses and will not give the recipient the flu. The nasal-spray flu vaccine is a live attenuated influenza vaccine (LAIV) that contains a live, weakened flu virus. The virus can potentially make a person sick with the flu.

People taking immunosuppressive drugs should get the flu shot, LAIV is not recommended for anyone who has a chronic disease, including IBD., or for people taking immunosuppressive medications.

A Word From Verywell

A flu shot is an important part of care for anyone who has IBD. Getting vaccinated helps protect against the flu and related complications. While it's never "too late" to get a flu shot, it's recommended that vaccination take place starting in October. The flu season spikes at different times across the country, and while it is somewhat predictable, it's best to get vaccinated early to have the best possible chance of avoiding the flu.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Flu Symptoms & Complications. September 18, 2019.

  2. Sands BE, Cuffari C, Katz J, Kugathasan S, Onken J, Vitek C, Orenstein W. Guidelines for immunizations in patients with inflammatory bowel disease. Inflamm Bowel Dis. Sep 2004. 08 Oct 2007. doi:10.1097/00054725-200409000-00028

Additional Reading

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.