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J Crohns Colitis. 2015 Jun;9(6):439-44. doi: 10.1093/ecco-jcc/jjv064. Epub 2015 Apr 23.

Vaccination in inflammatory bowel disease patients: attitudes, knowledge, and uptake.

Author information

1
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
2
Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
3
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada.
4
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada geoff.nguyen@utoronto.ca.

Abstract

BACKGROUND:

Immunomodulators and biological agents, used to treat inflammatory bowel disease [IBD], are associated with an increased risk of infection, including vaccine-preventable infections. We assessed patient attitudes towards vaccination, knowledge of vaccine recommendations, and uptake of recommended vaccines.

METHODS:

Patients attending IBD clinics completed a self-administered, structured, paper-based questionnaire. We collected demographic data, medical and immunisation history, self-reported patient uptake, knowledge, and perceptions of childhood and adult vaccinations.

RESULTS:

The prevalence of treatment with biologicals, steroids, thiopurines, and methotrexate among the 300 respondents were 37.3%, 16.0%, 16.0%, and 5.7%, respectively. Self-reported vaccine completion was reported by 45.3% of patients. Vaccination uptake rates were 61.3% for influenza, 10.3% for pneumococcus, 61.0% for hepatitis B, 52.0% for hepatitis A, 26.0% for varicella, 20.7% for meningococcus, 5.3% for herpes zoster, and 11.0% for herpes papilloma virus [females only]. Significant predictors of vaccine completion were annual vaccination review by family physician (odds ratio [OR] = 1.82) or gastroenterologist [OR = 1.72], current steroid use [OR = 1.28], and current or prior treatment with biologicals [OR = 1.42]. The majority of patients reported that the primary responsibility to ensure vaccine completion lies with the patient [41.7%] and the family physician [32.3%]. Uncertainty about indications, fears of side effects, and concerns regarding vaccine safety were the most commonly reported reasons for non-uptake [22.0%, 20.7%, and 5.3%, respectively].

CONCLUSIONS:

Uptake of recommended vaccines among IBD patients is suboptimal. Annual vaccination reviews by both family physician and gastroenterologist may improve vaccine uptake. Interventions targeted at improving vaccination uptake in IBD patients are needed.

KEYWORDS:

IBD; vaccination; vaccination uptake

PMID:
25908717
DOI:
10.1093/ecco-jcc/jjv064
[Indexed for MEDLINE]

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