Adherence to a predefined vaccination program in patients with inflammatory bowel disease.

INTRODUCTION: The application of vaccination programs in patients with inflammatory bowel disease (IBD) is heterogeneous and generally deficient. As a result, adherence in these patients to a predefined vaccination program has not been clearly established. The aim of this study was to estimate adherence to a predefined vaccination program among patients with IBD and to identify the factors that may predict poor adherence. METHODS: All patients diagnosed with IBD and followed-up between January and March 2012 were referred to the Department of Preventive Medicine for evaluation of their immune status (with serological testing for hepatitis A, B and C viruses, varicella-zoster virus, mumps, rubella and measles), followed by vaccination based on the test results obtained and on the patient's vaccination history. The percentage of adherence to the vaccination program was determined, along with the factors associated with low adherence. RESULTS: A total of 153 patients with IBD (ulcerative colitis in 50.3% and Crohn's disease in 49.7%) were included (45.1% men and 54.9% women; mean age 43.30±14.19 years, range 17-83). The vaccination program adherence rate was 84.3%. The factors associated with poor adherence were drugs related to IBD (patients not receiving immunosuppressants and/or biological agents showed lower adherence than those receiving these treatments; p=0.021), adherence to medical treatment (poor adherence to treatment was also associated with poor adherence to vaccination; p=0.016), and marital status (single, divorced or separated patients showed lower adherence than married individuals; p=0.015). CONCLUSION: Adherence to vaccination is acceptable among patients with IBD. However, specific actions, such as optimization of patient information on the disease and emphasis on the need for adequate vaccination, are to improve adherence.

[Adequate rate of response to hepatitis B virus vaccination in patients with inflammatory bowel disease]. / Eficacia de la vacuna contra el virus de la hepatitis B en pacientes con enfermedad inflamatoria intestinal.

BACKGROUND AND OBJECTIVE: Patients with Inflammatory Bowel Disease (IBD) may have an increased risk of developing hepatitis B virus (HB) infection. Invasive procedures such as colonoscopies and surgery might be some of the reasons for this. Moreover, the use of immunosuppressors may reactivate a latent infection. We assessed the immune status among IBD patients receiving HB vaccine and the circumstances that predicted its results. AIMS AND METHODS: Serological markers of B and C hepatitis virus in patients with IBD who were referred for consultation were assessed since 2006. The subsequent determination of antibodies against superficial antigen (HBsAb) could differentiate between responders and non responders to the vaccine and an adequate immunity to HB was defined as higher than 10mUI/ml. RESULTS: One hundred and twenty nine patients were included in our study. Fifty-six (43,4%) patients had received immunosuppressive medication before the first vaccine dose. Notably, 85 (65.9%) patients had inadequate levels of HBsAb: 36 had no detectable levels and 49 had less than 10mUI/ml. Younger patients had a better immunity response than older patients (30.91+/-14.8 vs 39.91+/-14.2) (p<0.001). CONCLUSION: More than half of the patients had a suboptimal serologic response after vaccination. Only the younger group showed a better rate of response. It was not demonstrated whether an additional fourth dose of vaccination or a complete revaccination improved the rate of responders.