The inflammatory bowel diseases (IBD) are a group of chronic intestinal diseases characterized by inflammation of the bowel. The most common types of IBD are ulcerative colitis and disease. Patient with moderate to severe disease often need to be treated with immunosuppressant medications or biologic therapy. Vaccination is an integral part of IBD care and should be administered early in the disease to avoid infections which may occur on immunosuppressant and biologic therapy. Additionally, patients on these medications should avoid live vaccination. We propose that patients are not adequately advised on the risks associated with live vaccination prior to the initiation of immunosuppressant or biologic therapy.Methods:
In a 6 month period, a total of 278 IBD patients were identified as having been seen in an urban, university-based gastroenterology practice. Reviewing the electronic health records, demographic information and documentation of counselling regarding the risk of live vaccine administration in patients concurrently treated with immunosuppression and biologic therapy were collected. All information was recorded in a secure data base preserving patient confidentiality and complying with the universities standards for PHI. Statistical analysis was performed with a significance of P < 0.05. The study was approved by the university Institutional Review Board.Results:
The study identified 275 patients with IBD, 163 with Crohn's disease and 112 with ulcerative colitis. There were 169 patients on immunosuppression and biologic therapy or both. There were 106 patient neither on immunosuppressant nor biologic therapy. Counselling about the use of live vaccination was not documented in any patients (P = 1).Conclusions:
IBD patient treated with immunosuppressant and biologic therapy are advised against receiving live vaccines. Patients starting or continuing either of these therapies should be advised to avoid these types of vaccination. Providers may be counselling patients, but may not be routinely documenting these discussions, limiting the outcomes described in this study. Further investigation is recommended.