Risk of Vaccine-Preventable Infections in Swiss Adults with Inflammatory Bowel Disease.


Journal

Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472

Informations de publication

Date de publication:
2021
Historique:
received: 18 11 2020
accepted: 14 03 2021
pubmed: 11 5 2021
medline: 6 11 2021
entrez: 10 5 2021
Statut: ppublish

Résumé

Patients with inflammatory bowel disease (IBD) have a higher risk of infection and are frequently not up to date with their immunizations. This study aims to review vaccination status and evaluate whether age, disease type, or treatment regimen could predict the absence of seroprotection against selected vaccine-preventable infection in adults with IBD. Cross-sectional study using questionnaire, immunization records review, and assessment of tetanus-specific, varicella-specific, and measles-specific immunoglobulin G concentrations. ClinicalTrials.gov: NCT01908283. Among the 306 adults assessed (median age 42.7 years old, 70% with Crohn's disease, 78% receiving immunosuppressive treatment), only 33% had an immunization record available. Absence of seroprotection against tetanus (6%) was associated with increasing age and absence of booster dose; absence of seroprotection against varicella (1%) or measles (3%) was exclusively observed in younger patients with Crohn's disease. There was no statistically significant difference in immunoglobulin concentrations among treatment groups. Although vaccinations are strongly recommended in IBD patients, the frequencies of participants with at least 1 dose of vaccine recorded were low for nearly all antigens: tetanus 94%, diphtheria 87%, pertussis 54%, poliovirus 22%, measles-mumps-rubella 47%, varicella-zoster 0%, Streptococcus pneumoniae 5%, Neisseria meningitidis 12%, hepatitis A 41%, hepatitis B 48%, human papillomavirus 5%, and tick-borne encephalitis 6%. Although many guidelines recommend the vaccination of IBD patients, disease prevention through immunization is still often overlooked, including in Switzerland, increasing their risk of vaccine-preventable diseases. Serological testing should be standardized to monitor patients' protection during follow-up as immunity may wane faster in this population.

Sections du résumé

BACKGROUND BACKGROUND
Patients with inflammatory bowel disease (IBD) have a higher risk of infection and are frequently not up to date with their immunizations.
OBJECTIVES OBJECTIVE
This study aims to review vaccination status and evaluate whether age, disease type, or treatment regimen could predict the absence of seroprotection against selected vaccine-preventable infection in adults with IBD.
METHODS METHODS
Cross-sectional study using questionnaire, immunization records review, and assessment of tetanus-specific, varicella-specific, and measles-specific immunoglobulin G concentrations. ClinicalTrials.gov: NCT01908283.
RESULTS RESULTS
Among the 306 adults assessed (median age 42.7 years old, 70% with Crohn's disease, 78% receiving immunosuppressive treatment), only 33% had an immunization record available. Absence of seroprotection against tetanus (6%) was associated with increasing age and absence of booster dose; absence of seroprotection against varicella (1%) or measles (3%) was exclusively observed in younger patients with Crohn's disease. There was no statistically significant difference in immunoglobulin concentrations among treatment groups. Although vaccinations are strongly recommended in IBD patients, the frequencies of participants with at least 1 dose of vaccine recorded were low for nearly all antigens: tetanus 94%, diphtheria 87%, pertussis 54%, poliovirus 22%, measles-mumps-rubella 47%, varicella-zoster 0%, Streptococcus pneumoniae 5%, Neisseria meningitidis 12%, hepatitis A 41%, hepatitis B 48%, human papillomavirus 5%, and tick-borne encephalitis 6%.
CONCLUSIONS CONCLUSIONS
Although many guidelines recommend the vaccination of IBD patients, disease prevention through immunization is still often overlooked, including in Switzerland, increasing their risk of vaccine-preventable diseases. Serological testing should be standardized to monitor patients' protection during follow-up as immunity may wane faster in this population.

Identifiants

pubmed: 33971650
pii: 000516111
doi: 10.1159/000516111
doi:

Substances chimiques

Vaccines 0

Banques de données

ClinicalTrials.gov
['NCT01908283']

Types de publication

News

Langues

eng

Sous-ensembles de citation

IM

Pagination

956-964

Informations de copyright

© 2021 The Author(s) Published by S. Karger AG, Basel.

Auteurs

Laure F Pittet (LF)

Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Charlotte M Verolet (CM)

Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Pierre Michetti (P)

Crohn's and Colitis Center, Gastroenterology Beaulieu SA, Lausanne, Switzerland.
Department of Medicine, Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Elsa Gaillard (E)

Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Marc Girardin (M)

Department of Medical Specialities, Gastroenterology Service, Geneva University Hospitals, Geneva, Switzerland.

Pascal Juillerat (P)

Service of Gastroenterology, Clinic of Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland.

Christian Mottet (C)

Service of Gastroenterology, Hôpital Cantonal, Sion, Switzerland.

Michel H Maillard (MH)

Crohn's and Colitis Center, Gastroenterology Beaulieu SA, Lausanne, Switzerland.
Department of Medicine, Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Claire-Anne Siegrist (CA)

Departments of Pathology-Immunology and Pediatrics, Centre for Vaccinology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Klara M Posfay-Barbe (KM)

Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

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