Clinical

IBD patients need better immunization

Last Updated: 2006-08-30 15:30:25 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Patients with inflammatory bowel disease (IBD) are frequently not immunized against vaccine-preventable diseases, despite their compromised immune status that puts them at high risk, according to researchers, who call for better efforts to vaccinate these patients.

Dr. Gil Y. Melmed of Cedars-Sinai Medical Center, Los Angeles, and colleagues had 169 patients from their IBD specialty clinic complete surveys with questions about immunization status, exposure to preventable diseases such as influenza, pneumococcus, varicella and viral hepatitis, and their general medical condition. One hundred forty-six (86%) reported taking immunosuppressive medications currently or in the recent past.

Only 45% recalled receiving a tetanus vaccination in the past 10 years, 28% received regular influenza vaccination and 9% reported recent pneumococcal vaccination, according to the report in the August issue of the American Journal of Gastroenterology.

Lack of awareness of the need for immunization, reported by 49%, was the number one reason for not receiving vaccines. Another 18% said they were concerned over possible side effects.

Although 44% were at risk of exposure to hepatitis B virus (HBV), only 28% had received the vaccine. Among those who reported a history of HBV vaccination, only 33% had measurable antibodies to hepatitis B surface antigen.

Dr. Melmed's group points out that patients who are going to receive immunosuppressive treatment, such as those about to have an organ transplant, are checked for immunization status and vaccinated accordingly before treatment begins.

The researchers conclude that there is a need for "a paradigm shift in the initial management of patients with IBD and other chronic illnesses who have a reasonable likelihood of future immunosuppression."

Am J Gastroenterol 2006;101:1834-1840.