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Poster presentations: Clinical: Therapy and Observation 2020

P489 Are patients with inflammatory bowel disease receiving an adequate immunisation?

D. Simian1, P. Núñez2, L. Flores1, C. Figueroa1, P. Ibáñez1, U. Kronberg1, J. Lubascher1, G. Pizarro1, R. Quera1

1Clínica Las Condes, Gastroenterology Department - Inflammatory Bowel Disease, Santiago, Chile, 2Gastroenterology Department - IBD Fellow Clínica Las Condes, San Juan de Dios Hospital, Santiago, Chile

Background

Inflammatory Bowel Disease (IBD) treatment may increase the risk of infections. Vaccines are part of the comprehensive IBD patient care. The aim of this study was to describe indications and adherence of immunisations in IBD and identify possible associated factors.

Methods

A cross-sectional, analytic study was conducted in patients from an IBD Program of a tertiary centre in Chile, between April – June 2019. Demographic and clinical data were obtained from the hospital IBD registry, approved by the local IRB. Patients were asked to answer a vaccine survey and complementary information was obtained from the National Immunization Registry. Descriptive and association statistic were used (χ2; p <0.05).

Results

A total of 243 patients were included (Table 1). The influenza vaccine rate has significantly increased (Figure 1), reaching 67% in 2019, being higher in women (66% vs. 34%; p 0.045) and patients in biological therapy (BT) (29% vs. 14%; p 0.011) (Table 1). Vaccination rates are shown in Figure 2. Combination of Influenza/Hepatitis B/Pneumococcus vaccines was administered in 56 patients (23%), significantly higher in patients with BT and with fewer years of IBD. Forty patients received a live virus vaccine, 18% were on immunomodulatory treatment. The survey showed that 57 patients (23%) have not been immunised with any vaccine, mainly due to lack of time, lack of medical prescription and high cost.

Table 1. Demographic and clinical characteristics of inflammatory bowel disease patients by Influenza vaccine 2019

Influenza vaccine 2019 n = 164 (67%)Without influenza vaccine 2019 N = 79 (33%)p value
Female109 (66)42 (53)0.045
Age in years (median; range)36 (18–78)37 (18–75)0.490
Insurance0.673
Private133 (81)66 (83)
Public31 (19)13 (17)
Educational level0.451
Basic/high school27 (17)11 (14)
College/university107 (65)47 (59)
Postgraduate studies30 (18)21 (27)
Smoking habit8 (5)23 (29)<0.001
Type of IBD0.221
Ulcerative colitis97 (59)51 (65)
Crohn’s disease63 (38)23 (29)
Non-classifiable IBD4 (3)5 (6)
Years of disease (median; range)5 (0–49)6 (6–47)0.603
IBD current treatment
5-ASA64 (39)38 (48)0.179
Immunomodulators36 (22)17 (22)0.879
Biological therapy47 (29)11 (14)0.011
Prednisone3 (2)1 (1)
Budesonide3 (2)3 (4)
CAM0 (0)1 (1)
Without treatment11 (7)8 (10)0.352

Figure 1. Influenza vaccine rates per year (2017–2019).

Figure 2. Vaccinations rates in patients with inflammatory bowel disease.

Conclusion

In this cohort, vaccination rates are low, however, adherence to Influenza vaccine has increased. Immunisation should be considered early by the multidisciplinary team, educating patients about its importance.