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P684 Vaccination strategies for IBD patients

A. Sitibondo*1, A. Squeri1, A. Viola1, G. Costantino1, A. Belvedere1, V. Pisana1, F. Costa2, R. Squeri2, W. Fries1

1AOU G. Martino, Department of Clinical and Experimental Medicine, IBD Unit, University of Messina, Messina, Italy, 2AOU G. Martino, Vaccination Centre, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy

Background

Several vaccinations are strongly recommended patients with inflammatory bowel disease (IBD), especially in those on immunosuppressive therapy or in elderly IBD patients. Unfortunately, adherence to vaccination programmes is poor. The aim of the present study was to test different strategies with regard to adherence.

Methods

we identified among our outpatients with IBD those with indication for vaccination for seasonal influenza and pneumococcus vaccination, that is, patients on immunomodulator or biotecnologic therapies, patients aged ≥65 years, and those with both indications. At start, in autumn 2016, all these patients were verbally informed during their outpatient visits, on the opportunity to follow recommendation for influenza vaccination. In the following year, autumn 2017, all patients were invited to adhere to vaccination by letter addressed to their primary care physician. At the end of the vaccination campaign (January 2018), all patients were interviewed (during visits or by telephone interview) to assess adherence to vaccination; in case of negative reply, the reasons for non-vaccination were investigated. Finally, a third strategy was employed for vaccination against pneumonia (Prevenar® ). In this setting, the patients were informed and directly vaccinated in our outpatient unit in collaboration with the Vaccination Centre of our hospital.

Results

Among the 1432 patients followed in our centre, indication for vaccination programmes were given in 341 patients on immunosuppressive therapy, in 100 elderly patients, and 60 patients with both indications. Adherence to verbal invitation for influenza vaccination was very low reaching only 19.6%, whereas written recommendation directed to primary care physicians did increase vaccination coverage reaching 51.7%. Reasons for non-vaccinating were safety concerns in 65.5%, scepticism about efficacy in 22.3%, forgetfulness in 11.2%, and in 1% vaccination was discouraged by their primary care physicians. Finally, the direct proactive strategy vaccinating patients directly in our Unit yielded an 89.67% adherence to pneumococcus vaccination.

Conclusion

Vaccination programmes based on patients’ collaboration or collaboration by their primary care physicians yielded poor adhesion not exceeding 51.7% %. A proactive approach, providing directly the vaccination during outpatients visits reached a considerable success rate and should be offered in IBD centres. Training programmes for primary care physicians may be useful to increase territory-based adherence to vaccination programmes.