Immunization Status of Patients With Inflammatory Bowel Disease

Abstract

BACKGROUND: Treatment for inflammatory bowel disease (IBD) includes a variety of immunosuppressants and biological agents, which increase the risk of infections due to altered cellular and humoral immunity. Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized. OBJECTIVE: Analyze the immunization status of patients with IBD and confront it with the current recommendations to verify if the immunization guidelines are being followed correctly. METHODS: Analytical cross-sectional study including 239 IBD patients being regularly followed in the Gastroenterology Service from Hospital de Clínicas da Universidade Federal do Paraná, which were subjected to a survey about their relevant demographic data and immunization status. RESULTS: The amount of patients that declared being unaware of their immunization status is high - between 34.3% (Tdap) and 52% (meningococcal) - excepting IIV, hepatitis B and HPV. The vaccines with the largest rates of patients declaring to have taken it are inactivated influenza vaccine (72.4%), BCG (55.3%), hepatitis B (48.3%), measles, mumps and rubella vaccine (43.8%) and DTaP (43%). The vaccines with the lowest rates of patients declaring to have taken it are Haemophilus influenza type b (0.8%), herpes zoster (2.1%) and HPV (3.4%). Patients that are being treated or have been treated with biological therapy have the largest immunization coverage for inactivated influenza vaccine (81%) and PPSV23 (25.9%), also they have the largest awareness rates for those vaccines. CONCLUSION: Although being a specialized service linked to a university hospital, vaccination coverage and patients’ awareness rates proved to be below the desirable level. Vaccination and recovery of the immunization history is recommended immediately after the diagnosis of IBD, regardless of the use of biological agents. Those findings support the need of implementing hospital guidelines and constantly verifying its application by the multidisciplinary team in specialized services in IBD.

Seroconversion Analysis After Habitual Hepatitis B Vaccination Scheme in Patients With Inflammatory Bowel Diseases

“…In our research, demographic data revealed the predominance of women, with an average age of 46 years, which corroborates with other studies, indicating a representative sample of the population (17) . Despite our reduced sample size with only 36 patients, we obtained statistically relevant variables, which will be discussed later.…”

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

“…The number of study participants reported ranged from 73 to 18,44,062 with a total of 4,338,331 participants; 4,336,836 (99.97%) were females and 1395 (0.03%) were males. Eight studies had included the male population [17À23], one had reported uptake among people living with HIV [24] and one reported uptake among people with inflammatory bowel disease [18]. Eleven studies reported using nationally representative data while 36 reported using sub-national samples.…”

“…Only one study reported the uptake of at least one dose of HPV by 1.5% (95/5153) among persons living with HIV [24]. Among patients with inflammatory bowel disease, the uptake was 3.3% (8/239) [18]. None of the studies in the LMICs reported HPV uptake among MSM.…”

Inmunización en Enfermedad Inflamatoria Intestinal: un indicador estándar de la calidad de atención que se debe mejorar

“…Pese a ello, diferentes estudios han mostrado que la inmunización sigue siendo subóptima 10 . Esta información proviene principalmente de Norteamérica, Europa y Asia, con solo dos estudios publicados in extenso desde Latinoamérica 11,12 . Uno de estos, es un estudio nacional observacional, descriptivo realizado en un único centro que incluyó 243 pacientes con EII, el cual mostró que las vacunas con los mayores porcentajes de administración fueron contra la influenza (67%), virus hepatitis B (VHB) (40%), neumocócica 13-valente (34%) y neumocócica 23-polisacárida (16%).…”

“…El acceso previo a esta Ley para pacientes con EC versus CU (2017 versus 2019) puede explicar las diferencias en los porcentajes de vacunación entre ambas enfermedades. No deja de llamar la atención que 20% de los pacientes refirieron no haber recibido ninguna vacuna debido a su alto costo 11 .…”