Introduction Patients with IBD remain at risk of preventable infections due to immunomodulatory drugs. The European Crohns and Colitis Organisation (ECCO) Consensus document1 recommends immunising all such patients to Human Papilloma Virus (HPV-in females under 18 years), Influenza, Pneumococcus and Hepatitis B (in seronegative patients). We investigated our practice over the last 5 years.
Methods All 29 patients contactable on our Biologics' Register agreed to take part. Twenty-six remained on maintainance biologics. All had received at least one immunomodulatory drug prior to their commencement. Patients were asked if they had been immunised or offered it prior to or during their biologic therapy.
Results Responses in Abstract PTU-094 table 1. While 83% were offered influenza immunisation—28% declined all invitations and a similar number declined yearly offers of the immunisation. This was despite a number of pandemic flu scares. All patients reported that influenza and pneumococcal vaccination occurred at the instigation of Primary Carers. All those who received Hepatitis B immunisation did so as a result of Occupational or Travel requirement and those who were offered HPV did so as part of other national recommendations.
Conclusion A recent survey of Australian Gastroenterologists found 30%–55% had never recommended such immunisations.2 Others have found that most Gastroenterologists feel that Primary carers are responsible.3 Primary carers however use National guidelines4 that have no specific recommendations for Hepatitis B and HPV in patients on immunosurpressants. Gastroenterologists therefore need to promote awareness of ECCO guidelines to ensure best coverage for patients as well as advocating standardisation in National and Professional guidelines.
Competing interests None declared.
References 1. Rahier JF, et al. European evidence-based Consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. Journal of Crohn's and Colitis 2009;3:47–91.
2. Gupta A, Macrae FA, Gibson PR. Vaccination and screening for infections with inflammatory bowel disease: a survey of Australian gastroenterologists. Internal Medicine Journal 2011;41:462–7.
3. Wasan SK, Skolnik PR, Farraye FA. A 24 Year Old patient with Crohn's disease starting immunosurpressive therapy: vaccination issues to consider. Clin Gastroenterol Hepatol 2010;8:1013–16.
4. Chapter 7 in Immunisations against infectious disease (the Green Book)-UK Dept of Health Online Guidelines. 2006 (Nov 2011 update).