New Initiatives Improve Vaccination Rates in Pediatric Patients with IBD

Data show that vaccination coverage is still low in patients with inflammatory bowel disease (IBD), due to barriers such as perceived lack of benefit, fear of side effects, and discomfort.

A new study aimed to improve effective strategies to increase influenza vaccination coverage and to evaluate vaccination practices in pediatric patients receiving biologic infusions.

Researchers, led by Sharmistha Rudra, MD of Children’s Hospital in Philadelphia, found that the initiative led to a 23.5% increase in vaccinations in IBD patients receiving biologic infusions.

The results were presented at the 2021 Digestive Disease Week Virtual Meeting.

Study

Researchers noted that there are approximately 1,700 patients in the IBD center.

In this patient population, there was an influenza vaccination rate of 40.3% for the IBD population and 45.5% for patients receiving biologic therapies at the infusion center (n = 772).

The new initiative to increase vaccination results by 20% at the end of the 2020-2021 flu season.

Researchers used plan-do-study-act cycle models, including the formation of a multidisciplinary team to assess vaccination barriers.

It also included the dissemination of a survey of healthcare professionals or IBD patients ≥ 18 years of age to investigate the vaccination decision-making process, awareness of recommendations, and the impact of vaccine availability in the infusion center on admission.

The team then optimized access for patients receiving biologic therapies with strategies including counseling sessions with ward providers and infusion center nurses.

Other strategies include establishing an electronic medical record (EMR) order set and active telephone screening of the population prior to infusion visits, when unvaccinated patients were offered the vaccine during the appointment.

The researchers used chi-square analyzes to compare survey responses between health care providers and patients, with 2 proportional sample tests identifying differences in vaccination coverage between 2 flu seasons.

Results

The survey was answered by 14.4% of the population, with 269 caregivers and 60 patients.

71.3% of respondents were on anti-TNF alpha, including infliximab or adalimumab, or vedolizumab and 13.4% were not vaccinated in 2019-2020.

The team found that 33% of patients who received biologic infusion treatment were interested in getting the vaccine at the time of the appointment.

Researchers noted that the main reasons for not vaccinating were “unsure about safety” (31.8%), “unsure about benefit” (29.5%) and “forgetting to schedule” (13.6%) .

Data show that both patients and caregivers had similar vaccine impressions, with researchers finding no statistically significant differences.

The researchers note that for the 2020-2021 season, 88.75% plan to be vaccinated and 51.7% have expressed interest in receiving the vaccine during the infusion appointment.

Conclusion

The team concluded that the implementation of the initiative has increased vaccination coverage by 23.5% in patients receiving biologic infusion treatment.

They noted that pre-appointment screening and access in conjunction with appointments were the most effective strategies to increase vaccination uptake.

“We plan to apply these effective QI strategies to optimize the uptake of COVID-19 vaccination in our IBD population,” the researchers wrote.

The study, “Improving Flu Vaccination in Pediatric Inflammatory Bowel Disease: A Quality Improvement Initiative,” was published online by DDW.

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