Background: Inflammatory Bowel Disease (IBD) confers an increased risk of opportunistic infection. Chronic inflammation and the use of steroids, thiopurines and biologic medications contribute to immunosuppression state. Ecco guidelines recommend checking the vaccination status before starting immunosuppressive agents and actively vaccinate them. However many studies have shown poor uptake of recommended vaccinations despite the guidelines and education n provided to them by GI health care providers.
In our department we have a dedicated IBD nurse specialist and we provide individual and quarterly group education sessions about different aspects of IBD for our patients. We provide written recommendations to the general practitioner and expect vaccines to be administered in the community.
The aim of this study was to assess patient awareness regarding importance of vaccination and their vaccination status
Methods: This is single centre observational study performed at a tertiary care centre in Dublin Ireland. A written questionnaire based on ECCO guidelines was developed with simple Yes/No answers. This was given to IBD patients at the outpatient clinics, Infusion suite and in the community. The data was analysed using microsoft excel
Results: A total of eighty nine patients completed the survey, 45 (51%) were male. Fifty two percent (47) had Crohn's. Average duration of the disease was 11 years (range 6ms to 46 years). At least 64% of them were exposed to steroids and similar numbers were on thiopurines. Sixty six percent had been or were being treated with an anti-tnf. One patient was on a combination of anti-tnf and of methotrexate.
Only 20% of patients responded that they knew about the vaccination recommendations and 18% responded that they were educated about the vaccination at some point in their disease course.
Fifteen percent have their up-to-date Pneumococcal vaccination while influenza vaccination was approximately 48%. Twenty one percent have been vaccinated against their hepatitis B. Regular cervical smear check was significantly better as compared to the vaccination which was around 64% of females
Conclusions: Despite having regular education sessions about the awareness and the importance of vaccination, the uptake of vaccination is very poor.
Our findings would suggest that despite education sessions and recommendations to GPs that uptake remains poor, therefore GI providers should take a more pro-active approach and offer vaccination as part of the ambulatory care management of our IBD patients