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Linked ContentThis article is linked to Philpott et al papers. To view these articles, visit https://doi.org/10.1111/apt.14573 and https://doi.org/10.1111/apt.15292.

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Background Patients with paediatric Inflammatory Bowel Diseases (p-IBD) and their families widely use the Internet as a resource and tend to read the first page of 10 results. However, online content may be of questionable quality, and valuable information may be hard to find. This study aimed to (i) determine the average quality of online information on p-IBD and (ii) analyze whether it depends on the source of information. Methods A google search was performed on the 28 October 2019 using the keywords: ‘Crohn’s disease’, ‘ulcerative colitis’, ‘Inflammatory Bowel Disease’, ‘colonoscopy’, ‘endoscopy’, all of them combined with the terms ‘paediatric’ and ‘children’. We recorded the first 10 results for each search and excluded scientific papers, advertisements, videos and sites requiring subscription. Websites were classified according to their origin as hospital, professional society, government agency, health press or patient organisations. The quality of the information was assessed with the DISCERN instrument, a validated 16-point questionnaire (total score 16–80) to evaluate the quality of written information. DISCERN scores were graded as excellent (68–80), good (55–67), fair (42–54), poor (29–41) or very poor (16–28). In order to minimise subjectivity, four evaluators assessed the quality, and the mean total score was calculated for every selected website. The proportion of websites with excellent or good grading in each category was compared using the Fisher test. Results We identified 100 websites and 65 met the inclusion criteria. The type of authorship and DISCERN scores are shown in Table 1. The overall median DISCERN score was 40.8 [interquartile range, IQR 10.5]. Only 5 websites had an excellent or good score. The proportion of websites with excellent or good grading was significantly higher in those from government agencies and professional societies (33.3% and 30% vs. 2% and 0%, p < 0.05). None of the health press websites showed excellent or good grading. Surprisingly, no websites from patient organisations were identified. Conclusion The quality of online information on p-IBD is highly variable. Most of the easily found websites are from hospitals, but professional societies and government agencies provide a higher quality of information. Improvement of online information on p-IBD is still needed.

Background Pediatric inflammatory bowel disease (PIBD) patients are especially prone to vaccine-preventable diseases and opportunistic infections. The aim was to evaluate the immunisation and vaccination status in PIBD. Methods Descriptive and retrospective study that analyses the immunisation and/or vaccination for measles, mumps and rubella (MMR), hepatitis B virus (HBV), chickenpox, cytomegalovirus (CMV) and Epstein–Barr virus (EBV) of PIBD patients in a tertiary paediatric hospital (January 2015- Oct 2019) in the first 6 months after diagnosis. Results Amongst 57 patients, 17 (30%) had ulcerative colitis (UC), 35 (61%) Crohn’s disease (CD) and 5 (9%) unclassified IBD (uIBD). Up to 35 (61%) were male and the mean age at diagnosis was 10.2 ± 4.1 years. A total of 18 (32%) were currently on biological treatment and 45 (79%) on immunosuppressants. The disease location in CD patients was L3 (Paris classification) in 22 (63%) and L4a in 13 (37%). Only 2 (6%) showed perianal involvement. From the UC patients, 11 (65%) were E4. A delayed growth was observed in 6 (10%), all CD patients. At diagnosis, 37 (65%) were HBV-vaccinated, 13 of them (35%) had a serological response and 22 (59%) had no response. Amongst the latter, 18 were re-vaccinated and 9 (50%) had a documented serological response. Up to 34 patients (60%) were MMR-vaccinated and 13 (38%) showed a complete response. Only 6 patients could be re-vaccinated. Up to 30 (52%) showed chickenpox immunisation. Only 4 of the non-immunised patients could be vaccinated and all of them responded to a single dose. Regarding CMV and EBV, 17 and 16 patients (46 and 43%) were IgG positive respectively, all of them were IgM negative. Patients with CD were more likely to need HBV re-vaccination than other IBDs (p < 0.05). Regarding chickenpox, CD patients without growth delay (G0) needed less re-vaccination than those whose growth was affected (G1) (p < 0.05). However, UC patients with extensive disease (E4) needed less re-vaccination than those with limited disease (p < 0.05). Male patients seemed to be less likely to need re-vaccination, with no significant differences. Conclusion The serological assessment of vaccine-preventable diseases immunisation yielded poor results. Remarkably, a high percentage of HBV and MMR vaccinated patients showed no response. CD patients tended to more likely need revaccination, especially in the most severe cases (G1). Surprisingly, severity was not related with vaccination response in UC. Our results suggest that less than half of the patients had been previously infected by CMV or EBV. Based on this, it seems reasonable to serologically check the immunisation status in PIBD patients in order to, when appropriate, re-vaccinate before starting immunosuppressive therapies.