P516 Immunisation status and factors influencing vaccination decision-making in patients with inflammatory bowel disease
E. Waszczuk1, K. Waszczuk*2, A. Mulak1, L. Szenborn2, L. Paradowski1
1Wroclaw Medical University, Department of Gastroenterology and Hepatology, Wroclaw, Poland, 2Wroclaw Medical University, Department of Pediatrics and Infectious Diseases, Wroclaw, Poland
Patients with inflammatory bowel disease (IBD) are at higher risk of severe course of infections. Immunisations are recommended for this group of patients but the vaccine uptake is very low. However, it has not been yet investigated in the Polish population of IBD patients.
The aim of the study was to assess the vaccination status in patients with IBD and factors influencing patient opinion about immunisation. An author-designed survey was conducted among IBD patients hospitalised in the Department of Gastroenterology and Hepatology from November 2013 to March 2014. The survey was comprised of the following sections: demographic information, medications used for IBD treatment, vaccination history, vaccine-preventable disease history and patient attitude toward vaccination. Patients who have not received influenza vaccines were asked to complete a multiple-choice type question about the reasons for non-immunisation. Randomly, patients completed the survey in the presence of physician to verify comprehension of the questions. In order to provide test-retest reliability a group of ten patients completed it twice. The chi-squared test was used to compare categorical variables.
The survey was completed by 143 IBD patients (73 men), 60% with colitis ulcerosa, 40% with Crohn's disease. Mean age was 37 yrs (range 16-91 yrs). Most often patients reported hepatitis B (HBV) vaccination, 64%; then influenza, 35%; and tetanus, 12%; vaccines. There was a very poor uptake of hepatitis A and pneumococcal vaccines: 8% and 3%, respectively. As many as 24% of the patients did not know if they had received any vaccine. In 35% of the subjects at least one influenza vaccination was performed, but only 7% of them were receiving this vaccine annually. The uptake of influenza vaccine depended on the educational level: primary, 13%; secondary, 32%; tertiary, 44%; (p=0.046), while there was no influence of patient place of residence (village vs town, p=0.77). The reasons for influenza vaccine refusal were: no information from physician (51%); unawareness of the recommendations (38%); fear of vaccines side effects (28%); patients' doubts regarding vaccines efficacy (25%); vaccination costs (2%). Predominantly a gastroenterologist was chosen as the most reliable source of vaccines information (72%).
In Poland a vaccine uptake recommended for IBD patients, except for HBV vaccine, is very poor. There is a need to increase awareness among health care providers and their patients concerning immunisation guidelines. Gastroenterologists should be more involved in active vaccine promotion especially regarding pneumococcal and influenza vaccines. Patients with IBD should be equipped with a reliable documentation regarding vaccination.