IBD and vaccine preventable diseases

Abstract

Background and Aims: Patients with IBD are often treated with immunosuppressives. Data suggest that vaccines are underutilized in immunocompromised patients, despite guidelines recommending their use, putting them at higher risk for infections. The purpose of this study was to evaluate pediatric gastroenterologists' knowledge of vaccination recommendations and to determine their understanding of safe use of vaccines prior to starting immunosuppressives. Methods: An anonymous electronic survey was administered to the national pediatric gastroenterology attending and fellow listserve. The survey included (Table presented). 12 questions about vaccine screening practices and knowledge. Results: Of 166 total responses, 62% report they know the latest vaccine schedule recommendations, and 67.5% ask IBD patients about vaccine status. To verify immunization status, 82% accept verbal affirmation, 24% check the vaccine card, and 18% check hospital/clinic records. Before starting immunosuppressives, 55% confirm up to date immunization status, and 65% do not require IBD patients to be up to date prior to starting immunosuppressives. Table 33 shows results of pediatric gastroenterolosists' knowledge about IBD, immunosuppressives and vaccines. Conclusions: Our findings suggest that the majority of pediatric gastroenterologists are familiar with vaccine schedules, but a gap in knowledge exists regarding vaccine related concerns in IBD patients on immunosuppressives. The increased risk of cervical cancer is under appreciated in IBD patients. Though many are screening immunization status, most are through verbal affirmation which may not be accurate. Many patients are placed on immunosuppressives despite not being up to date on their immunizations, placing them at greater risk of infection.