Compliance with the guidelines on recommended immunization schedule in patients with inflammatory bowel disease: implications on public health policies

BMC Public Health. 2020 May 19;20(1):713. doi: 10.1186/s12889-020-08850-y.

Abstract

Background: Patients with inflammatory bowel disease (IBD) have a higher risk of developing opportunistic infections due to either the disease itself or to treatment with immunosuppressants. This risk can be reduced through vaccination. The aim of this study was to determine the prevalence of compliance with the guidelines on recommended immunization schedule in patients with IBD in the health district of Lleida, Spain.

Methods: Descriptive, cross-sectional, retrospective study of data at December 31, 2016. The reference population was formed by adults with a clinical diagnosis of IBD. The dependent variable was "compliance with the guidelines on recommended immunization schedule". Variables were sex, age, residence, diagnosis, vaccination against measles, mumps, rubella, varicella, tetanus-diphtheria, influenza, pneumococcus, meningococcus C, hepatitis B, and hepatitis A. Data were obtained from electronic medical records. For the data analysis, mean (standard deviation), prevalence with 95% confidence intervals, χ2 test and Mann-Whitney test were used.

Results: Compliance did not exceed 65% for any of vaccines analysed in the 1722 studied patients with ulcerative colitis or Crohn's disease. Significant differences across age groups were found in compliance for measles, mumps, rubella, varicella, tetanus, diphtheria and influenza in both ulcerative colitis and Crohn's disease and for meningococcus C and hepatitis A exclusively in ulcerative colitis.

Conclusions: Compliance in patients with IBD is low. Thus, prevention of immunopreventable diseases or their complications is not maximized in this kind of patients. Greater awareness of how vaccines can reduce the risk of vaccine-preventable infections is needed among both patients and healthcare professionals.

Keywords: Epidemiology; Immunization schedule; Inflammatory bowel disease; Public health.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / immunology
  • Colitis, Ulcerative / psychology
  • Crohn Disease / drug therapy
  • Crohn Disease / immunology
  • Crohn Disease / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunization Schedule
  • Immunosuppressive Agents / adverse effects
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / immunology
  • Inflammatory Bowel Diseases / psychology*
  • Male
  • Opportunistic Infections / immunology
  • Opportunistic Infections / prevention & control*
  • Patient Compliance / statistics & numerical data*
  • Prevalence
  • Retrospective Studies
  • Vaccination / statistics & numerical data*
  • Vaccines / therapeutic use*
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Vaccines