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P290 Compliance to vaccination guidelines in patients with immune-mediated inflammatory diseases: a cross-sectional, single-centre study

S. Coenen*1, D. Bertrand2, T. Vanhoutvin3, P. Verschueren4, P. De Haes3, P. De Munter5, S. Vermeire1, M. Ferrante1

1UZ Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium, 2KU Leuven, Skeletal Biology and Engineering Research Center, Leuven, Belgium, 3UZ Leuven, Department of Dermatology, Leuven, Belgium, 4UZ Leuven, Department of Rheumatology, Leuven, Belgium, 5UZ Leuven, Department of Infectious Diseases, Leuven, Belgium

Background

Despite the elevated risk for vaccine-preventable diseases and infection-related complications in patients with immune-mediated inflammatory diseases (IMID), vaccination coverage is still far from optimal. In 2015, we reported that only 32% of our patients with inflammatory bowel disease (IBD) were completely vaccinated according to guidelines.1 We evaluated the evolution of vaccination coverage between 2015 and 2018 in IBD patients, and compared the current coverage with other IMID patients.

Methods

Between August 2018 and October 2018, the vaccination status of 829 consecutive IMID patients (43% male, median age 50 years) was collected at the outpatient clinics of a tertiary referral centre (63% gastroenterology, 34% rheumatology, 3% dermatology). A one-page vaccination questionnaire was completed by the treating physician and reasons for non-vaccination were recorded. Missing data were added after contact with the general practitioner.

Results

Among IBD patients, vaccination rates had increased significantly from 2015 to 2018, namely 62% vs. 74% for pneumococci (p < 0.001), 53% vs. 67% for hepatitis B (p < 0.001), and 32% vs. 45% for all vaccines (p < 0.05) (see Image 1). One hundred and one patients were included in both IBD cohorts. Sixty-seven were not completely vaccinated according to guidelines in 2015 and 30 of them (45%) changed vaccination behaviour in the last 3 years. Analysis of the current vaccination status demonstrated that overall 39% of the IMID patients were completely vaccinated according to guidelines (see Image 1). Vaccination rates were significantly greater in IMID patients followed at the gastroenterology department vs. patients followed at rheumatology, namely 74% vs. 36% for pneumococci (p < 0.001), 67% vs. 45% for hepatitis B (p < 0.001), 82% vs. 73% for tetanus (p < 0.01), and 45% vs. 27% for complete vaccination according to guidelines (p < 0.001) (see Image 1). Regarding dermatology patients, IBD patients more frequently received a hepatitis B vaccination (67% vs. 46%, p < 0.05). Scepticism (24% for influenza) and non-awareness (47% for pneumococci, 38% for hepatitis B and 42% for tetanus booster) were the most commonly reported reasons for non-vaccination.

Vaccination rates.

Conclusion

Approximately 40% of all IMID patients were completely vaccinated according to guidelines. Although recent efforts on vaccination education in IBD patients have significantly improved vaccination rates, there is still need for awareness in both patients and healthcare professionals.

Reference

1. Coenen S, Weyts E, Jorissen C, et al. Effects of education and information on vaccination behavior in patients with inflammatory bowel disease. Inflamm Bowel Dis 2017;23:318–24.