Introduction With a recent paradigm shift in IBD management, biologics are being used earlier in disease course, often in combination with immunomodulators. This poses significant immunosuppression and infection risk. Optimised vaccination uptake provides an opportunity to reduce serious infection risk from preventable illness in patients with IBD.
European Crohn’s and Colitis Organisation (ECCO) have produced consensus guidelines on vaccinations for this patient group.1
Method Our aim was to assess whether patients on biologic treatment (as single or combination therapy with immunomodulators) are receiving vaccinations in line with ECCO guidelines.
We identified patients treated with biologics (adalimumab/infliximab) for IBD at Royal Preston Hospital from an established database. GP Practices were contacted in the Central Lancashire area and asked to complete a cross sectional survey using their electronic records detailing what vaccinations patients had received and whether they were listed for recall.
Results Out of 100 surveys sent to GP practices, 58 were returned. The average patient age was 41 years. 43 (74.1%) had a diagnosis of Crohn’s and 15 (25.9%) of ulcerative colitis. Influenza vaccine had the highest uptake at 62.1% and 74.1% on recall (3 of these had other medical indications for vaccination). For all other vaccines uptake was low ranging 0% (shingles) to 46.6% (MMR). The data on vaccinations is detailed in the table below:
Conclusion The uptake of vaccinations among IBD patients on biologics is low. With the use of biologics likely to increase in this patient population, targeted interventions aimed at improving vaccination rates are needed. Recent studies have shown systematic educational initiatives in primary and secondary care can improve vaccination rates(2). Formal annual reviews focusing on health maintenance measures and development of collaborative pathways between primary and secondary care may help remove barriers to implementation of guidelines.
. Rahier JF, Magro F, Abreu C, et al.
. Christensen K, Steenholdt C, Buhl S at al. Systematic Information to Health-Care Professionals about Vaccination Guidelines Improves Adherence in Patients With Inflammatory Bowel Disease in Anti-TNFα Therapy. Am J Gastroenterol. 2015;110(11):1526–32.
Disclosure of Interest None Declared