P463 COVID-19 vaccination willingness and hesitancy in patients with Inflammatory Bowel Diseases (IBD): analysis of determinants in a national survey of the Italian IBD patients’ association (AMICI Onlus).

Costantino, A.(1);Noviello, D.(2);Conforti, F.S.(1);Aloi, M.(3);Armuzzi, A.(4);Bossa, F.(5);Ficari, F.(6);Leone, S.(7);Manguso, F.(8);Mocci, G.(9);Orlando, A.(10);Pironi, L.(11);Radice, S.(12);Rizzello, F.(13);Tongiorgi, A.(14);Costantino, C.(15);Vecchi, M.(1,2);Caprioli, F.(1,2);

(1)IRCCS Ca’ Granda Ospedale Maggiore Policlinico Foundation, Gastroenterology and Endoscopy Unit, Milan, Italy;(2)University of Milan, Department of Pathophysiology and Transplantation, Milano, Italy;(3)Sapienza University of Rome, Department of Pediatrics, Rome, Italy;(4)Fondazione Policlinico Universitario A. Gemelli IRCCS, Internal Medicine and Gastroenterology, Rome, Italy;(5)Fondazione casa sollievo della sofferenza, Gastroenterologia ed Endoscopia Digestiva, San Giovanni Rotondo, Italy;(6)AUO Careggi, Dipartimento di Medicina Sperimentale Clinica Chirurgia Generale, Florence, Italy;(7)AMICI onlus, AMICI onlus, Milan, Italy;(8)AO Cardarelli, Surgical Department, Napoli, Italy;(9)Azienda Ospedaliera ARNAS G. Brotzu, SC Gastroenterologia, Cagliari, Italy;(10)“Villa Sofia-Cervello” Hospital, IBD Unit, Palermo, Italy;(11)Policlinico Sant'Orsola Malpighi Centro IICB, Scienze Mediche, Bologna, Italy;(12)Humanitas Research Hospital, IBD Unit, Milan, Italy;(13)Policlinico Sant'Orsola Malpighi, Department of Internal Medicine and Gastroenterology, Bologna, Italy;(14)UO Gastroenterologia AOUP, Chirurgia Generale, Pisa, Italy;(15)Department of Health Promotion Sciences- Maternal and Infant Care- Internal Medicine and Excellence Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy


Vaccine hesitancy, the delay in acceptance or refusal of vaccination despite its availability, represents a threat to the diffusion and lethality of infectious diseases. COVID-19 vaccination has been recommended by national and international organizations in patients with Inflammatory Bowel Diseases (IBD). The aim of the study was to evaluate COVID-19 vaccine willingness and hesitancy in a population of Italian patients with IBD, and their determinants.


In February 2021 an online questionnaire focused on COVID-19 vaccine was proposed to a representative sample of Italian IBD patients. Socio-demographic characteristics, IBD features, lifestyle, perception of COVID-19, general attitude towards vaccinations and to COVID-19 vaccines were investigated. Patients were divided into willing, hesitant and refusive towards COVID-19 vaccine. The hesitation reasons were investigated. The associations between baseline characteristics and willingness (determinants) were evaluated by calculating crude and adjusted Odds Ratio (AdjOR) with 95% confidence intervals (CI).


The baseline characteristics are shown below. 1252 surveys were collected. 1005 (80.3%), 222 (18.1%) and 33 (2.63 %) patients were defined as willing, hesitant and refusive, respectively. Concerns for vaccine adverse effects constituted the main reason for refusal (73.4%) (Figure). 49.1% of hesitant patients reported that presence of IBD exerted an influence on their answer. Among the patients willing to be vaccinated whenever possible, 78.2% (786) thought that their IBD represented a valid motivation to access vaccination with priority. Willingness to COVID-19 vaccine was significantly associated with adherence to previous vaccinations (AdjOR 17.6, 95% CI 11.4-27.2), male gender (1.68 95% CI 1.16-2.43), graduation degree (1.48, 95% CI 1.03-2.13), perceived higher risk of COVID-19 due to IBD (1.47, 95% CI 1.05-2.08), alcohol intake (1.69, 95% CI 1.16-2.45). Conversely, the hesitancy was significantly associated with use of complementary and alternative medicines (0.58, 95% CI 0.36-0.92). Notably, 54.5% of patients were under the impression to have a higher risk of COVID-19 and 31.8% a more severe course due to their IBD.

Age, years, median (IQR)48 (37-58)
Female, n (%)729 (58.2%)
Disease type, n (%)
-CD613 (48.9%)
-UC612 (48.9%)
Disease duration, n (%)
-≤ 5 years161 (12.9%)
-> 5 years1,091 (87.1%)
Past surgeries475 (37.9%)
Immunosuppressive drug584 (46.7%)


Most IBD patients would accept COVID-19 vaccines, though one out of five is hesitant to date, principally due to fear of adverse events. The knowledge of determinants and reasons for COVID-19 vaccination acceptance could be a key element in developing targeted communication strategies to address vaccine hesitancy.