Patients with Inflammatory Bowel Disease Are at Risk for Vaccine-Preventable Illnesses

Melmed, Gil Y.; Ippoliti, Andrew; Papadakis, Konstantinos A.; Tran, Tram T.; Birt, Jaime L; Lee, Susie K.; Frenck, Robert W.; Targan, Stephan R.; Vasiliauskas, Eric A.

doi:10.1111/j.1572-0241.2006.00646.x

Cited by 297 publications

(211 citation statements)

References 27 publications

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“…Patients with IBD are oft en treated with long-term immunesuppressive therapies and may thus be at increased risk for infections, many of which are preventable with vaccinations ( 14 ). In general, adherence to age-appropriate vaccination schedules is recommended, although special considerations exist for patients receiving or initiating immunosuppressive therapies ( 10,11,15 ).…”

Section: Vaccinationsmentioning

confidence: 99%

“…Several studies have documented poor uptake of routine vaccinations among patients with IBD ( 14,20 ). In one study of 169 IBD patients seen at an IBD center, of 145 patients on current or previous immunosuppression, only 28% reported regular fl u shots and only 9% received the pneumococcal vaccine ( 14 ).…”

Section: Vaccinationsmentioning

confidence: 99%

“…In one study of 169 IBD patients seen at an IBD center, of 145 patients on current or previous immunosuppression, only 28% reported regular fl u shots and only 9% received the pneumococcal vaccine ( 14 ). Common reasons for low rates of vaccination included patient lack of awareness and fear of side eff ects.…”

Section: Vaccinationsmentioning

confidence: 99%

“…Several studies have demonstrated that the most patients with IBD do not receive adequate vaccinations across multiple diff erent healthcare settings ( 7,14,(32)(33)(34)(35)(36)(37)(38)(39)(40). Th is seems to refl ect defi ciencies in provider knowledge both from gastroenterologists and primary care practitioners ( 6,8,41 ).…”

Section: Summary Of Evidencementioning

confidence: 99%

See 3 more Smart Citations

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

403

421

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Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

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Section: Vaccinationsmentioning

confidence: 99%

Section: Vaccinationsmentioning

confidence: 99%

Section: Vaccinationsmentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 99%

See 2 more Smart Citations

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

403

421

View full text Add to dashboard Cite

show abstract

“…In fact, screening for HBV should be performed at diagnosis of IBD, rather than waiting until initiation of therapy with immunomodulators or tumour necrosis factor-a (TNF) antagonists. 1,[13][14][15] This recommendation is based on the potential fatal consequences of HBV reactivation and the availability of safe and effective anti-HBV drugs to prevent reactivation. 1 However, no consensus has been reached for HCV screening prior to starting immunomodulators.…”

Section: Which Ibd Patients Should Be Screened For Prior Hbv ⁄ Hcv Exmentioning

confidence: 99%