Specific author contributions: Richard Fedorak conceived and designed the study and edited the article. James Yeung created the data collection forms, performed the surveys, analyzed the data, and wrote the abstract and the article. Karen Goodman, a member of the Division of Gastroenterology and School of Public Health, contributed input to the questionnaire design and analysis and reviewed drafts of the article.
Article first published online: 18 FEB 2011
Copyright © 2011 Crohn's & Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 1, pages 34–40, January 2012
How to Cite
Yeung, J. H., Goodman, K. J. and Fedorak, R. N. (2012), Inadequate knowledge of immunization guidelines: A missed opportunity for preventing infection in immunocompromised IBD patients. Inflamm Bowel Dis, 18: 34–40. doi: 10.1002/ibd.21668
Funded through grants from the Crohn's and Colitis Foundation of Canada and the Centre of Excellence for Gastrointestinal Inflammation and Immunity Research.
- Issue published online: 11 DEC 2011
- Article first published online: 18 FEB 2011
- Manuscript Accepted: 6 JAN 2011
- Manuscript Received: 30 SEP 2010
- Crohn's disease;
- ulcerative colitis;
Immunosuppressive agents, used commonly to treat inflammatory bowel disease (IBD), are associated with an increased risk of infections, including those preventable by immunization. This study aimed to describe physician and patient values and knowledge regarding immunization and immunization histories.
In all, 167 IBD patients and 43 gastroenterologists completed mail-out questionnaires. Patients were asked 15 questions about their immunization histories and attitudes towards immunization. Gastroenterologists were asked nine questions about immunization for the immunocompromised host.
The questionnaire return rate was 45.7% (43/94) for gastroenterologists and 25.2% (167/661) for patients. Only 14.3% (6/42) of gastroenterologists reported taking an immunization history from most or all of their patients. Only 5.4% (9/167) of patients recalled being asked by their gastroenterologist whether their immunizations were up to date, and just 0.6% (1/164) recalled being asked for a detailed immunization history. Overall, 21.7% (35/161) of patients had refused to be immunized in the past; 18.6% (8/43) of gastroenterologists did not know if up-to-date immunizations were important prior to starting immunosuppressive therapy. Of note, 23.1% (9/39) of gastroenterologists and 46.7% (35/161) of patients did not know whether live vaccines should be avoided by those in the immunosuppressed state, and 42.9% (18/43) of gastroenterologists acknowledged they did not know which specific immunizations should be avoided for immunosuppressed patients.
Gastroenterologists have limited knowledge of their IBD patients' immunization status and rarely take an adequate immunization history. Substantial proportions of IBD patients and gastroenterologists lack adequate knowledge of established immunization guidelines prior to initiation of immunosuppressive therapy. (Inflamm Bowel Dis 2011;)