Vaccination for influenza and pneumococcus in patients with gastrointestinal cancer or inflammatory bowel disease: A prospective cohort study of methods for improving coverage

Sitte, Julien; Frentiu, E.; Baumann, Cédric; Rousseau, Hélène; May, Thierry; Bronowicki, Jean–Pierre; Peyrin–Biroulet, Laurent; Lopez, Anthony

doi:10.1111/apt.15057

Cited by 25 publications

(20 citation statements)

References 24 publications

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“…Vaccination among adults including those older than 65 years has been shown to be efficient [40]. Healthcare professionals, cancer societies, and other societies advocate for increasing this vaccination rate, which some vaccination programs increased successfully [36]. Cardiovascular diseases are the leading cause of mortality of diabetic patients [41], which may explain the lack of a signal due to diabetes mellitus in our model.…”

Section: Discussionmentioning

confidence: 96%

“…A recent French study showed a 10% rate among patients with comorbidities at risk [12]. A single-institution study focusing on 99 patients with gastrointestinal cancer yielded a pneumococcal vaccination rate of 10.1% (95% CI [4.1-16]) [36]. As shown in several studies, childhood vaccination programs contribute to herd immunity, thus partly protecting non-vaccinated adults [37,38].…”

Section: Discussionmentioning

confidence: 98%

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Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs

et al. 2021

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Background Community-acquired pneumonia (CAP), especially pneumococcal CAP (P-CAP), is associated with a heavy burden of illness as evidenced by high rates of intensive care unit (ICU) admission, mortality, and costs. Although well-defined acutely, determinants influencing long-term burden are less known. This study assessed determinants of 28-day and 1-year mortality and costs among P-CAP patients admitted in ICUs. Methods Data regarding all hospital and ICU stays in France in 2014 were extracted from the French healthcare administrative database. All patients admitted in the ICU with a pneumonia diagnosis were included, except those hospitalized for pneumonia within the previous 3 months. The pneumococcal etiology and comorbidities were captured. All hospital stays were included in the cost analysis. Comorbidities and other factors effect on the 28-day and 1-year mortality were assessed using a Cox regression model. Factors associated with increased costs were identified using log-linear regression models. Results Among 182,858 patients hospitalized for CAP in France for 1 year, 10,587 (5.8%) had a P-CAP, among whom 1665 (15.7%) required ICU admission. The in-hospital mortality reached 22.8% at day 28 and 32.3% at 1 year. The mortality risk increased with age > 54 years, malignancies (hazard ratio (HR) 1.54, 95% CI [1.23–1.94], p = 0.0002), liver diseases (HR 2.08, 95% CI [1.61–2.69], p < 0.0001), and the illness severity at ICU admission. Compared with non-ICU-admitted patients, ICU survivors remained at higher risk of 1-year mortality. Within the following year, 38.2% (516/1350) of the 28-day survivors required at least another hospital stay, mostly for respiratory diseases. The mean cost of the initial stay was €19,008 for all patients and €11,637 for subsequent hospital stays within 1 year. One-year costs were influenced by age (lower in patients > 75 years old, p = 0.008), chronic cardiac (+ 11% [0.02–0.19], p = 0.019), and respiratory diseases (+ 11% [0.03–0.18], p = 0.006). Conclusions P-CAP in ICU-admitted patients was associated with a heavy burden of mortality and costs at one year. Older age was associated with both early and 1-year increased mortality. Malignant and chronic liver diseases were associated with increased mortality, whereas chronic cardiac failure and chronic respiratory disease with increased costs. Trial registration N/A (study on existing database)

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs

et al. 2021

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“…A prospective cohort study evaluating the impact of a specialized infectious disease consultation on vaccination coverage rates in patients with gastrointestinal cancer or IBD showed this consultation could significantly improve patients’ knowledge about vaccination and vaccination coverage [ 17 ]. This approach could be applied to improve COVID-19 vaccination in IBD patients.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease and COVID-19 Vaccination: A Patients’ Survey

2021

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Background Vaccination against COVID-19 is a major public health challenge, including the community of patients with inflammatory bowel disease. Vaccination coverage is suboptimal in inflammatory bowel disease population. It is of paramount importance to ensure an effective and rapid vaccination program with the adherence of the largest number of well-informed patients. Aims We assessed the acceptance of COVID-19 vaccination among inflammatory bowel disease patients. Methods We performed a survey as part of routine practice, between January 8th and February 22nd, 2021. All consecutive adult patients followed at Nancy University Hospital for inflammatory bowel disease were included. Patients completed a self-administered, structured, paper-based questionnaire. Demographic data, medical history, knowledge, and perceptions of COVID-19 vaccination were collected. Results Among the 104 patients who responded to the survey, 57 patients (54.8%) had intent to receive the COVID-19 vaccine. Vaccine efficacy, social responsibility, herd immunity, and desire to return to normal life were associated with self-reported willingness to receive a vaccine (20.2%, 20.2%, 11.5%, and 15.4%, respectively). Unknown long-term safety, risk of adverse reaction to vaccine and concern that the vaccine is being developed too quickly were the most commonly reported reasons for non-uptake (27.9%, 15.4%, and 12.5%, respectively). Conclusion Half of the patients with inflammatory bowel disease would like to be vaccinated against SARS-CoV-2. This rate is similar to that reported in the French general population. Despite some concerns, patients with inflammatory bowel disease understood the necessity to be vaccinated against COVID-19.

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Section: Intervention To Improve Vaccination Ratementioning

confidence: 99%

“…The other 3 studies [33 , 37 , 47] also utilized education (in the form of written educational form [33] , education by the IBD nurse with help of an information brochure and vaccination card [37] , and vaccination educational update by an infectious disease specialist [47] ) to improve the vaccination rate. The study by Sitte et al [47] recruited patients with gastrointestinal cancer (GC) or IBD. There was significant improvement in vaccination rate: in GC patients, pneumococcal vaccination rate increased from 10.1% to 87.5% after the specialized consultation, whereas the corresponding rates were 16.1% and 85.7%, respectively, for IBD patients.…”

Section: Intervention To Improve Vaccination Ratementioning

confidence: 99%

Vaccinations and inflammatory bowel disease – a systematic review

Chan¹,

Salazar²,

Lim³

et al. 2021

Digestive and Liver Disease

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Introduction: Patients with inflammatory bowel disease(IBD) are at risk of infections, many of which are preventable with vaccinations. We performed a systematic review on various aspects of vaccination in IBD. Methods: We searched PubMed, and EMBASE databases, through 31 January 2021. Primary outcomes included vaccination rates, predictors of vaccination, reasons of vaccination hesitancy and acceptance, and outcomes of intervention. Findings were presented with medians, ranges, and narrative synthesis. Results: We included 33 observational studies comprising 146,918 patients and 681 physicians. The median vaccination rates of influenza, pneumococcal pneumonia, and hepatitis B vaccines were 42%(IQR, 28%-61.5%), 20%(IQR, 9%-38.5%), and 48%(IQR, 29%-53%), respectively. Uses of immunosuppressant, older age and physician recommendations have positive influence on vaccination rate. Lack of vaccine-related knowledge and awareness of need for vaccination are main reasons of vaccine hesitancy among patients and physicians. There was disagreement between gastroenterologists and primary-care physicians on whose responsibility to offer vaccination. Education was the sole intervention identified, with variable success. Conclusion:This systematic review demonstrates that the vaccination rates of IBD patients, similar to other chronic diseases, are suboptimal. Lack of vaccine-related knowledge and awareness of the need for vaccination are main reasons of vaccine hesitancy amongst patients and physicians. Education, though effective, was the only available intervention identified. Gastroenterologist could take the lead in educating, and initiating vaccination among IBD patients.

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Vaccination for influenza and pneumococcus in patients with gastrointestinal cancer or inflammatory bowel disease: A prospective cohort study of methods for improving coverage

Cited by 25 publications

References 24 publications

Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs

Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs

Inflammatory Bowel Disease and COVID-19 Vaccination: A Patients’ Survey

Vaccinations and inflammatory bowel disease – a systematic review

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