P247. Uptake in the UK of vaccination recommendations in inflammatory bowel disease (IBD)
D. Burger1, W. Blad1, L. White1, A. Walsh2, S. Travis1
1John Radcliffe Hospital, Gastroenterology Unit, Oxford, United Kingdom; 2St Vincent's Hospital, Sydney, Australia
Background: Vaccine preventable illness provides an opportunity for reducing infective complications associated with medical therapy for IBD. We examined patient uptake of vaccination recommendations based on ECCO guidelines.
Methods: An A4-size vaccination checklist was introduced for routine clinic consultations at the IBD clinic, John Radcliffe Hospital, Oxford, with one copy each to the patient, GP, notes and research file. A covering letter explaining the initiative was given to patients and accompanied the recommendations to the GP. Patients were contacted by telephone 3 months after clinic review to audit the uptake of these recommendations.
Results: 182 patients were screened with the vaccination checklist over a 3‑month period (September November, 2010), with 146/182 (80%) follow up at 3 months. Median age was 39 (range 1775), 64% female; 56% had Crohn's disease, 35% ulcerative colitis and 9% IBD‑U. 60/146 (41%) were taking immunomodulators and 39/146 (27%) anti-TNFα therapy. Of 146 respondents, vaccine uptake was 119 (82%) against influenza (including H1N1), 69 (47%) against Pneumococcus spp., and 50 (35%) against hepatitis B. No patients had serological evidence of past or current hepatitis B or Hepatitis C. Only 2 (1%) of patients did not have immunity to varicella. Qualitative feedback from primary care, identified barriers to hepatitis B and pneumococcal vaccination for this patient group, which are not currently endorsed by the UK Department of Health. Hepatitis B seroconversion data are in progress.
Conclusions: Apart from influenza, there is low uptake of vaccination recommendations, with only a third of patients receiving hepatitis B vaccination. This may be due to the vaccination system in the UK, where patients with IBD are not explicitly included among those considered at risk.