1
|
Bianchi FP, Polignano M, Carella N, Rotolo O, Curlo M, Mastronardi M. Role of gastroenterologists and healthcare providers in promoting COVID-19 immunization among individuals with inflammatory bowel disease: A systematic review and meta-analysis on a global scale. Hum Vaccin Immunother 2024; 20:2349319. [PMID: 38755111 DOI: 10.1080/21645515.2024.2349319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals with Inflammatory Bowel Disease (IBD) are more susceptible to experiencing severe complications of COVID-19 if infected. Nevertheless, sub-optimal immunization rates have been reported among these patients. Our study aims to assess COVID-19 VH among a global population of patients with IBD and to investigate the role of healthcare professionals, particularly gastroenterologists, in promoting immunization. Twenty-six studies were systematically selected from scientific articles in the MEDLINE/PubMed, WoK, and Scopus databases from January 1, 2020, to September 15, 2023. The pooled prevalence of COVID-19 VH was 27.2% (95%CI = 20.6-34.2%). A significant relationship was evidenced between COVID-19 vaccine compliance and receiving advice from gastroenterologists or healthcare providers (OR = 2.77; 95%CI = 1.79-4.30). By leveraging their knowledge of IBD, familiarity with patient histories, and trusted patient-doctor relationships, gastroenterologists are pivotal in promoting vaccination. This patient-centered care is crucial in increasing vaccine acceptance among individuals with IBD, contributing to better public health outcomes.
Collapse
Affiliation(s)
| | - Maurizio Polignano
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Nicola Carella
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Ornella Rotolo
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Margherita Curlo
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Mauro Mastronardi
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| |
Collapse
|
2
|
Beniwal-Patel P, Waclawik G, Browning K, Urmat A, Schell TL, Smith R, Huerta A, Hipp L, Dave S, Shah N, Dillon KE, Reiter-Schreurs K, Russ RK, Mailig MA, Osman F, Farraye FA, Weiss J, Hayney MS, Caldera F. Racial, Ethnic, and Geographic Disparities in Immunization Rates Among Patients With Inflammatory Bowel Disease. CROHN'S & COLITIS 360 2023; 5:otad078. [PMID: 38130948 PMCID: PMC10734681 DOI: 10.1093/crocol/otad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims Racial and ethnic disparities exist in the treatment of IBD. These disparities exist in adult vaccine uptake among the general population and may extend to patients with IBD. The primary aim of this study was to determine whether racial, ethnic, or geographic disparities existed in influenza vaccine uptake among patients with IBD. Methods We performed a multicenter, retrospective cohort study evaluating adult vaccine uptake among patients with IBD seen at two tertiary referral centers between September 2019 and February 2020. The primary outcome was to determine if racial/ethnic and geographic disparities existed in influenza vaccine uptake for the two prior seasons. Our secondary outcomes were to determine if disparities existed for pneumococcal, zoster, or hepatitis B vaccines. Results Among the 2453 patients who met the inclusion criteria, most identified as non-Hispanic White (89.9%), were on immunosuppressive therapy (74.5%), and received the influenza vaccine in both seasons (56.0%). Older age (prevalence ratio (PR) 0.98; 95% confidence interval (95%CI) 0.98-0.99; P < .001) and non-Hispanic White patients (PR 0.76, 95%CI 0.59-0.98, P < 0.03) were significantly more likely to be immunized. Black patients (PR 1.37; 95%CI 1.18-1.59; P < .001) and those living in underserved geographic areas (PR 1.35; 95%CI 1.17-1.56; P < 0.001) were less likely to be immunized. Racial/ethnic and geographic disparities were identified for pneumococcal, zoster, and hepatitis B vaccine uptake. Conclusions Racial and ethnic vaccination uptake disparities exist among patients with IBD; patients from medically underserved areas are also vulnerable to these disparities Studies identifying patient, provider, and system-level opportunities to address these disparities are needed.
Collapse
Affiliation(s)
- Poonam Beniwal-Patel
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Gabrielle Waclawik
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Keely Browning
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Aijan Urmat
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Trevor L Schell
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Ryan Smith
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Antonio Huerta
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Lauren Hipp
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sonya Dave
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Neemit Shah
- Depatrment of Medicine, Medical College of Wisconsin School of Medicine, Milwaukee, WI, USA
| | - Kayla E Dillon
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Rachel K Russ
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Miguel A Mailig
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer Weiss
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| |
Collapse
|
3
|
Sullivan KM, Farraye FA, Winthrop KL, Willer DO, Vink P, Tavares-Da-Silva F. Safety and efficacy of recombinant and live herpes zoster vaccines for prevention in at-risk adults with chronic diseases and immunocompromising conditions. Vaccine 2023; 41:36-48. [PMID: 36460534 DOI: 10.1016/j.vaccine.2022.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022]
Abstract
Compared with the general population, older adults with immune senescence and individuals who are immunocompromised (IC) due to disease or immunosuppressive therapy are at increased risk for herpes zoster (HZ) and its associated complications, which can be debilitating and life-threatening. Vaccination can be an effective strategy against HZ and studies have shown that HZ vaccination in IC individuals can elicit immune responses and provide protection from infection. Recently, the first approvals have been granted in the United States and the European Union for the recombinant HZ vaccine (RZV) in adults ≥ 18 years of age at risk of HZ due to immunodeficiency or immunosuppression. Existing systematic reviews have highlighted the risks for HZ in limited immunocompromising conditions and have only examined clinical data for RZV. This review details the risks and burden of HZ in a broad range of clinically relevant IC populations and summarizes key efficacy and safety data for RZV and live HZ vaccine in these individuals. Research has shown IC individuals can benefit from HZ vaccination; however, these insights have yet to be fully incorporated into vaccination guidelines and clinical care. Clinicians should consider HZ vaccination in eligible at-risk populations to protect against HZ and its associated complications and thereby, reduce the burden that HZ poses on the healthcare system. Electronic health records and linked personal health records could be used to identify and contact patients eligible for HZ vaccination and provide clinical decision support-generated alerts for missing or delayed vaccinations. This review will help clinicians identify eligible IC individuals who may benefit from HZ vaccination. A video abstract linked to this article is available on Figshare https://doi.org/10.6084/m9.figshare.21517605.
Collapse
Affiliation(s)
- Keith M Sullivan
- Duke University Medical Center, 200 Trent Dr, Durham, NC 27710, USA.
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
| | - Kevin L Winthrop
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239, USA.
| | - David O Willer
- GSK Vaccines, 100 Milverton Drive Suite 800, Mississauga, ON, Canada.
| | - Peter Vink
- GSK Vaccines, 14200 Shady Grove Rd, Rockville, MD 20850, USA.
| | | |
Collapse
|
4
|
Health Care Maintenance in Patients with Crohn's Disease. Gastroenterol Clin North Am 2022; 51:441-455. [PMID: 35595424 DOI: 10.1016/j.gtc.2021.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Health care maintenance is critical for patients with inflammatory bowel disease (IBD), particularly for those receiving immunosuppressive medications. Vaccination recommendations for potentially preventable diseases, cancer prevention recommendations, and assessment of bone health and mood disorders are discussed in this article. Staying up to date with health care maintenance is of utmost importance, and all gastroenterologists caring for patients with IBD should be able to make recommendations regarding preventative care of these patients.
Collapse
|