Vaccinations and inflammatory bowel disease – a systematic review

Abstract

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.

COVID-19 Vaccination Willingness and Hesitancy in Patients With Inflammatory Bowel Diseases: Analysis of Determinants in a National Survey of the Italian IBD Patients’ Association

“…Regarding vaccinations in IBD patients, a recent systematic review has shown a low acceptance rate, ranging between 11% and 54%. 5 In the present study, we report that more than 4 in 5 (80.3%) IBD patients were ready to be vaccinated. In our study, determinants associated with COVID-19 vaccination willingness at the multivariate analysis were adherence to previous vaccinations, a perceived higher risk of COVID-19 due to IBD, male gender, degree, and alcohol intake.…”

Inflammatory Bowel Disease – An Update for Primary Care Physicians

“…[34][35][36] While several international guidelines have been published, 37,38 vaccination rates in patients with IBD remain suboptimal and lower than those in the general population. In a recent systematic review, 39 the median rates of vaccination against influenza, pneumococcal pneumonia, hepatitis B, and herpes zoster were reported at 42 percent, 20 percent, 48 percent, and 11 percent, respectively. 39 The low vaccination rate could be related to patient and physician factors.…”

“…In a recent systematic review, 39 the median rates of vaccination against influenza, pneumococcal pneumonia, hepatitis B, and herpes zoster were reported at 42 percent, 20 percent, 48 percent, and 11 percent, respectively. 39 The low vaccination rate could be related to patient and physician factors. The reasons for vaccine hesitancy among IBD patients, defined as a delay in acceptance or refusal of vaccination despite availability of vaccination services, 40 include concern about vaccine side effects, 41 lack of awareness about the importance and safety of vaccines in immunocompromised patients, 41 and misconceptions about vaccination.…”

Patients with inflammatory bowel disease are more hesitant about Coronavirus disease 2019 vaccination

“…Vaccine hesitancy in IBD patients is not a novel concern to gastroenterologists. Prior studies have shown that IBD patients are less likely to receive vaccinations made necessary from their immunocompromised state ( 10 ). Some concerns from the past have transferred to COVID-19 vaccines.…”