Can we better protect patients with inflammatory bowel disease against infections - patient attitude and personal immunization knowledge

Background and Study Aims : Inflammatory bowel disease (IBD) predisposes patients to a severe course of infections yet adherence to vaccination guidelines is low. Little is known about IBD patient attitude towards immunizations. We aimed to investigate patient attitude towards vaccinations and its influence on personal immunization coverage. Patients and Methods : A self-completed survey was completed by 195 IBD patients. The author-designed questionnaire comprised: demographic data, IBD medical history, vaccination history, reasons of influenza vaccine refusal, and the most reliable source of information about immunizations. Moreover, patients were asked if they agree with the statement that immunizations are beneficial for a person with IBD. Results : 99 patients (50%) claimed that prevention of infectious diseases is beneficial for a person with IBD but this opinion had no influence on recommended vaccination uptake. There was suboptimal vaccination coverage : hepatitis B (55%); diphteria, pertussis, tetanus (12%); hepatitis A (7%); annual influenza (6%); varicella-zoster (3%), and pneumococcal vaccine (2%). Top reasons for nonvaccination were: lack of information from a physician (47,5%), unawareness (35%), perceived lack of benefit (33%) and concerns about adverse events (26%). The most reliable source of information concerning immunizations was a gastroenterologist for the majority of IBD patients (58%) while more than 35% chose their general practitioner. Conclusions : Active promotion and information regarding beneficial role of immunizations among IBD patients and other chronically ill individuals significantly improves the quality of care. It is important to explain misconceptions about vaccines by the most reliable sources. We propose implementing an uniformed "immunization chart" for every chronically ill individual. (Acta gastroenterol. belg., 2018, 81, 257-261).