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Vaccinations and inflammatory bowel disease – a systematic review

  • Author Footnotes
    1 Webber Chan: planning and conducting the study, literature search, collecting and interpreting data, and drafting the manuscript.
    Webber Chan
    Correspondence
    Corresponding author.
    Footnotes
    1 Webber Chan: planning and conducting the study, literature search, collecting and interpreting data, and drafting the manuscript.
    Affiliations
    Department of Gastroenterology and Hepatology, Singapore General Hospital Singapore
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  • Author Footnotes
    2 Ennaliza Salazar: conducting of the study, collecting and interpreting data
    Ennaliza Salazar
    Footnotes
    2 Ennaliza Salazar: conducting of the study, collecting and interpreting data
    Affiliations
    Department of Gastroenterology and Hepatology, Singapore General Hospital Singapore
    Search for articles by this author
  • Author Footnotes
    3 Teong Guan Lim: conducting of the study, collecting and interpreting data
    Teong Guan Lim
    Footnotes
    3 Teong Guan Lim: conducting of the study, collecting and interpreting data
    Affiliations
    Department of Pharmacy, Singapore General Hospital, Singapore
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  • Author Footnotes
    4 Wan Chee Ong: conducting of the study, collecting and interpreting data
    Wan Chee Ong
    Footnotes
    4 Wan Chee Ong: conducting of the study, collecting and interpreting data
    Affiliations
    Department of Pharmacy, Singapore General Hospital, Singapore
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  • Author Footnotes
    5 Hang Hock Shim: planning and conducting of the study, literature search, collecting and interpreting data, and drafting the manuscript.
    Hang Hock Shim
    Footnotes
    5 Hang Hock Shim: planning and conducting of the study, literature search, collecting and interpreting data, and drafting the manuscript.
    Affiliations
    Parkway East Medical Center, 319 Joo Chiat Place, Singapore 427989
    Search for articles by this author
  • Author Footnotes
    1 Webber Chan: planning and conducting the study, literature search, collecting and interpreting data, and drafting the manuscript.
    2 Ennaliza Salazar: conducting of the study, collecting and interpreting data
    3 Teong Guan Lim: conducting of the study, collecting and interpreting data
    4 Wan Chee Ong: conducting of the study, collecting and interpreting data
    5 Hang Hock Shim: planning and conducting of the study, literature search, collecting and interpreting data, and drafting the manuscript.

      Abstract

      Introduction

      Patients with inflammatory bowel disease(IBD) are at risk of infections, many of which are preventable with vaccinations. We performed a systematic review on various aspects of vaccination in IBD.

      Methods

      We searched PubMed, and EMBASE databases, through 31 January 2021. Primary outcomes included vaccination rates, predictors of vaccination, reasons of vaccination hesitancy and acceptance, and outcomes of intervention. Findings were presented with medians, ranges, and narrative synthesis.

      Results

      We included 33 observational studies comprising 146,918 patients and 681 physicians. The median vaccination rates of influenza, pneumococcal pneumonia, and hepatitis B vaccines were 42%(IQR, 28%–61.5%), 20%(IQR, 9%–38.5%), and 48%(IQR, 29%–53%), respectively. Uses of immunosuppressant, older age and physician recommendations have positive influence on vaccination rate. Lack of vaccine-related knowledge and awareness of need for vaccination are main reasons of vaccine hesitancy among patients and physicians. There was disagreement between gastroenterologists and primary-care physicians on whose responsibility to offer vaccination. Education was the sole intervention identified, with variable success.

      Conclusion

      This systematic review demonstrates that the vaccination rates of IBD patients, similar to other chronic diseases, are suboptimal. Lack of vaccine-related knowledge and awareness of the need for vaccination are main reasons of vaccine hesitancy amongst patients and physicians. Education, though effective, was the only available intervention identified. Gastroenterologist could take the lead in educating, and initiating vaccination among IBD patients.

      Keywords

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      Linked Article

      • Immunization in patients with inflammatory bowel disease: Still far from standards
        Digestive and Liver DiseaseVol. 53Issue 11
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          We have recently read with great interest the manuscript, entitled “Vaccinations and inflammatory bowel disease – a systematic review” from Chan W et al. [1]. It is a systematic review that summarizes the literature on vaccination rates and predictors, reasons of vaccine hesitancy and interventions to improve vaccination rates in inflammatory bowel disease (IBD) patients. We agree with the most important message of the article, that there is a significant deficiency in immunization schedules in IBD patients.
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