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P453 Insufficient vaccination and inadequate immunisation rates amongst Korean patients with inflammatory bowel diseases

H. H. Ryu1, H.-S. Lee2, B. D. Ye*3, N. Y. Kim4, E. J. Youn3, J. Y. Park3, E. Kang3, S. W. Hwang1, S. H. Park3, D.-H. Yang1, K.-J. Kim3, J.-S. Byeon1, S.-J. Myung1, S.-K. Yang3

1University of Ulsan College of Medicine, Asan Medical Centre, Gastroenterology, Seoul, South Korea, 2University of Ulsan College of Medicine, Asan Medical Centre, Health Screening and Promotion Centre, Seoul, South Korea, 3University of Ulsan College of Medicine, Asan Medical Centre, Gastroenterology, Inflammatory Bowel Disease Centre, Seoul, South Korea, 4University of Ulsan College of Medicine, Asan Medical Centre, Clinical Epidemiology and Biostatistics, Seoul, South Korea

Background

Although there are clear guidelines for vaccination strategies in patients with inflammatory bowel diseases (IBD), recent studies have reported undervaccination and poor immunisation amongst IBD patients. The aims of this study were to evaluate current vaccination rates, immunity, and knowledge of and attitudes towards vaccination in Korean patients with IBD, as well as to identify factors associated with proper vaccination.

Methods

Between November 2013 and February 2015, consecutive patients with IBD were invited to complete a standardised questionnaire on vaccination. In addition, immune status was evaluated by serologic tests on common vaccine-preventable diseases. Factors associated with receiving adult vaccines were identified using multivariate logistic regression analysis.

Results

In total, 287 patients were enrolled (male, 188 [67.6%]; median age at survey, 29 years [range, 16–69]; duration of IBD, median 7 months [interquartile range, 1–35]; ulcerative colitis = 165; and Crohn’s disease = 122). Only a small proportion of patients replied that they had ever received vaccines against the following diseases; hepatitis A (HAV) (13.2%), hepatitis B (HBV) (35.2%), seasonal influenza (43.2%), and pneumococcus (4.9%). Most of the patients (87.1%) did not know the recommended vaccines for IBD, and only 20.6% had ever been recommended vaccination by their physicians. Out of 54 patients (18.8%) who had knowledge on definition of live vaccines, only 15 patients (27.8%) replied that live vaccines should be avoided during anti-tumour necrosis factor therapy. In contrast to over 70% of protective IgG antibody-positivity to measles virus (74.2%), mumps virus (82.2%), rubella virus (73.2%), and varicella zoster virus (85.0%), up to 64.8% and 32.8% of patients were negative for IgG anti-HAV antibody, and IgG HBV surface antibody, respectively. In multivariate analysis, age under 40 at survey (odds ratio [OR] 2.17, p = 0.011), recommendation on vaccination from a physician (OR 2.65, p = 0.006), newspaper subscription (OR 2.74, p = 0.004), and use of anti-tumour necrosis factor agents (OR 4.91, p = 0.041) showed significant association with up taking adult vaccines recommended for IBD patients.

Conclusion

Only a small proportion of IBD patients is getting vaccinated properly, and most IBD patients have insufficient knowledge on recommended vaccination. Inadequate protective antibody levels raise concerns for risk of HAV and HBV infection in a substantial proportion of IBD patients. Proper educational information and recommendation by physicians could help to increase awareness on need of vaccination and vaccination rates of IBD patients (ClinicalTrials.gov registration number: NCT01984879).