P403 Adherence to vaccination recommendations in patients with Inflammatory Bowel Disease: a long way for improving.
Ferreiro Iglesias, R.(1);Hernández Camba, A.(2);Saldaña, R.(3);Rodríguez-Lago, I.(4);Zabana, Y.(5);Barreiro-de Acosta , M.(1);
(1)Servicio de Gastroenterología. Hospital Clínico Universitario de Santiago. Fundación Instituto de Investigación Sanitaria de Santiago de Compostela IDIS-, Gastroenterology Department, Santiago, Spain;(2)Hospital Universitario Nuestra Señora de Candelaria, Gastroenterology Department, Tenerife, Spain;(3)ACCU Spain, Managing Director, Madrid, Spain;(4)Hospital Universitario de Galdakao, Gastroenterology Department, Bilbao, Spain;(5)Hospital Universitari Mútua de Terrassa. Centro Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas CIBERehd, Gastroenterology Department, Barcelona, Spain; On behalf of Young Group of GETECCU and ACCU
Background
Despite the existence of specific recommendations, patients with inflammatory bowel disease (IBD) have shown low immunization rates. The aim of this study was to evaluate the adherence to vaccination recommendations by physicians to their IBD patients.
Methods
An online anonymous survey was sent to 8000 patients from a national patient association (ACCU-Spain). Three invitations were sent between October-December 2020. Questions were jointly designed by ACCU and GETECCU. Potential reasons for vaccination compliance were evaluated and analysed for different vaccines: age, gender, type of IBD, type of healthcare and treatments. Descriptive analyses and logistic regression were performed to identify factors associated with adherence to vaccination recommendations.
Results
1302 patients with IBD responded to the survey (mean age 43 years [SD 12], 72% women). Forty percent of patients had ulcerative colitis, 58% Crohn’s disease and 2% indeterminate colitis. 91% of patients were treated in public facilities, 5% in a private setting and 4% in both. 41% of patients were treated with 5ASA, 35% with azathioprine/methotrexate, 50% with biologics and 8% with corticosteroids. Although [IRL1] [YZ2] physicians recommended vaccination, 45% were not adherent to papilloma virus vaccine, 18% to pneumococcus, 18% to hepatitis B vaccine, 16% to influenza and 12% to tetanus. The main reason for non-compliance to physician recommendation was considering that is not necessary (Table 1). Some factors associated to vaccine compliance are shown in Table 2.
Table 1. Adherence to vaccination recommendations in patients with Inflammatory Bowel Disease
| Adherence to vaccination recommendations | ||||||
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Forgetfulness | Fear of adverse events | Lack of confidence in the doctor | Not consider it necessary | Others | ||
| Influenza | 84% | 5,3% | 25% | 2% | 29% | 47% |
| Pneumococcal | 82% | 7,5% | 11% | 1% | 19% | 63% |
| Hepatitis B | 82% | 1,5% | 7,3% | 0,3% | 18% | 75% |
| Tetanus | 88% | 4,1% | 4,4% | 0,7% | 24% | 68% |
| Papilloma virus | 55% | 2,1% | 4,4% | 0,9% | 28% | 63% |
Table 2. Factors associated with adherence to different vaccination recommendations.
| Type of vaccine | Factors | OR | 95% IC | p |
|---|---|---|---|---|
| Influenza | Treatment with azathioprine | 0.580 | 0.379-0.888 | 0.012 |
| Pneumococcal | User of both healthcare systems | 0.186 | 0.035-0.977 | 0.047 |
| Travelling advice | Treatment with biologics | 0.469 | 0.324-0.677 | <0.001 |
| Hepatitis B | Treatment wit corticosteroids | 3.758 | 1.446-9.767 | 0.007 |
| Travelling advice | Treatment with mesalamine | 1.514 | 1.006-2.277 | 0.047 |
Conclusion
Non-adherence to vaccination recommendations in IBD patients is frequent. Patients with immunosuppressive therapy show less compliance to the vaccination recommendations. The importance and benefits of vaccination needs to be explained to improve the adherence in IBD patients.