Immunization Rates Poor for IBD Patients, Young Family Members

By Anne Harding

NEW YORK (Reuters Health) - Most inflammatory bowel disease (IBD) patients don't seem to be using the cocoon strategy to protect themselves from infectious disease, according to a new study from Poland.

While this approach, which involves protecting immunosuppressed individuals by immunizing their close contacts, is recommended by the European Crohn's and Colitis Organization, Dr. Karolina Waszczuk and colleagues from Wroclaw Medical University found "insufficient" use of nonmandatory vaccines among IBD patients' family members.

IBD patients are at greater risk of infections -- and severe complications of these infections -- than the general population, Dr. Waszczuk and her team write in the March issue of European Journal of Gastroenterology and Hepatology.

This is because they are often on immunosuppressant medications, they add, but is also due to IBD-related malnutrition. "However, vaccination coverage in IBD patients is very poor, mainly because neither gastroenterologists nor their patients are aware of any existing recommendations," the researchers write.

In the current study, the investigators surveyed 136 hospitalized IBD patients, 56 of whom lived with children. Patients were asked whether their child had been immunized against pneumococcus, influenza, varicella and rotavirus.

Among the patients, just 2% had received the pneumococcal vaccine, 7% had the flu shot, and 2% had been immunized against varicella. Just 40% of the children had received at least one recommended vaccination. Twenty-six percent received the pneumococcal vaccine and 22% had the rotavirus vaccine. Just over half of patients who did not immunize their children said they did not do so because they thought it was not necessary.

In Poland, the Ministry of Health pays for mandatory vaccines for children, which include hepatitis B; tuberculosis; tetanus, diphtheria and pertussis; Haemophilus influenzae; polio; and measles, mumps and rubella, the researchers note. Hepatitis A, varicella, influenza, pneumococcal, meningococcal, rotavirus and human papilloma virus vaccines are recommended, they add, but not covered and must be self-funded.

More-educated patients were more likely to have had their children immunized with the nonmandatory vaccines. While 28% of the patients could not remember whether or not they'd had varicella, none of these patients and none of their children had received the varicella vaccine.

"We would like to emphasize that IBD patients can be protected against some infectious diseases by  household member vaccination," Dr. Waszczuk said. "It is especially important for IBD patients living with children who can easily transmit infectious pathogens like rotaviruses, influenza viruses, Streptococcus pneumoniae, and varicella zoster virus."

She added: "Physicians have a key role in the care of chronically ill patients. Thus, they should optimize the long-lasting strategy of treatment and prevention. Patients have serious doubts regarding vaccinations, mostly because of an anti-vaccination movement which creates a lot of misunderstanding and fear. That is the role of primary care physician and other doctors to answer those questions based on current medical knowledge."

SOURCE: https://bit.ly/1CB7xKH

Eur J Gastroenterol Hepatol 2015;27:249-53.

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