The Immunization status of patients with Inflammatory bowel disease at a tertiary care hospital in South India : A retrospective study

Abstract

    Introduction : Inflammatory bowel  disease (IBD) is an immune related disease It often requires use of             immunomodulators (IM) and/or biologic agents (BA)               increasing susceptibility to infections. Most of these           infections can be prevented by vaccination.IBD patients should be vaccinated as per the standard guidelines for the general population. Aims and Objectives: To study status of Immunization program for IBD patients, how effectively program is getting implemented and to provide recommendations to match any inadequacies  in                 comparison to the present standards. Methods : This is a retrospective study done at a tertiary care hospital                   recruiting IBD patients.Detailed demography, history, examination, surgeries, complications,                                      co-morbidities, treatment history and vaccination status were taken from hospital records. Fifty IBD patients with definitive diagnosis were included in study over a period of January to June 2017 .IBD patients prior to                         implementation of Immunization program, Prior                  vaccination, comorbidities precluding use of vaccine& active disease were excluded. Results:58% (60% in UC and 56% in CD) patients not received any vaccination. Only 14% patient received two or more vaccinations                 (3 vaccines in single patient). Out of those who not received any vaccination 55% patients were already on IMs(azathioprine). Among patients who received any               vaccination 48% were on IMs .None of the study group patients received complete immunization as per institute protocol. Summary and recommendations: A zealous effort should be undertaken to vaccinate all IBD patients as per present standards by periodically educating treating physician, IBD staff and patients, proper patient              counseling.In our study there were inadequacies at              multiple levels as discussed above and should be                addressed promptly and adequately so that a high class standard of care for IBD patients can be maintained.