Department of Pediatrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Crohn's and Colitis Center, Gastroenterology Beaulieu SA, Lausanne, Switzerland.
Digestion. 2021;102(6):956-964. doi: 10.1159/000516111. Epub 2021 May 10.
Patients with inflammatory bowel disease (IBD) have a higher risk of infection and are frequently not up to date with their immunizations.
This study aims to review vaccination status and evaluate whether age, disease type, or treatment regimen could predict the absence of seroprotection against selected vaccine-preventable infection in adults with IBD.
Cross-sectional study using questionnaire, immunization records review, and assessment of tetanus-specific, varicella-specific, and measles-specific immunoglobulin G concentrations. ClinicalTrials.gov: NCT01908283.
Among the 306 adults assessed (median age 42.7 years old, 70% with Crohn's disease, 78% receiving immunosuppressive treatment), only 33% had an immunization record available. Absence of seroprotection against tetanus (6%) was associated with increasing age and absence of booster dose; absence of seroprotection against varicella (1%) or measles (3%) was exclusively observed in younger patients with Crohn's disease. There was no statistically significant difference in immunoglobulin concentrations among treatment groups. Although vaccinations are strongly recommended in IBD patients, the frequencies of participants with at least 1 dose of vaccine recorded were low for nearly all antigens: tetanus 94%, diphtheria 87%, pertussis 54%, poliovirus 22%, measles-mumps-rubella 47%, varicella-zoster 0%, Streptococcus pneumoniae 5%, Neisseria meningitidis 12%, hepatitis A 41%, hepatitis B 48%, human papillomavirus 5%, and tick-borne encephalitis 6%.
Although many guidelines recommend the vaccination of IBD patients, disease prevention through immunization is still often overlooked, including in Switzerland, increasing their risk of vaccine-preventable diseases. Serological testing should be standardized to monitor patients' protection during follow-up as immunity may wane faster in this population.
炎症性肠病（IBD）患者感染风险较高，且经常未及时接种疫苗。
本研究旨在回顾评估成人 IBD 患者的疫苗接种情况，并评估年龄、疾病类型或治疗方案是否可预测针对特定疫苗可预防感染的血清无保护作用。
采用问卷调查、免疫记录回顾和破伤风、水痘、麻疹特异性免疫球蛋白 G 浓度评估进行的横断面研究。ClinicalTrials.gov：NCT01908283。
在 306 例接受评估的成人患者中（中位年龄 42.7 岁，70%为克罗恩病，78%接受免疫抑制治疗），仅 33%的患者可提供免疫记录。破伤风（6%）血清无保护作用与年龄增加和缺乏加强剂量相关；水痘（1%）或麻疹（3%）血清无保护作用仅见于年轻的克罗恩病患者。各组间免疫球蛋白浓度无统计学显著差异。尽管强烈建议 IBD 患者接种疫苗，但几乎所有抗原的记录至少接种 1 剂的参与者比例都较低：破伤风 94%，白喉 87%，百日咳 54%，脊髓灰质炎 22%，麻疹-腮腺炎-风疹 47%，水痘-带状疱疹 0%，肺炎链球菌 5%，脑膜炎奈瑟菌 12%，甲型肝炎 41%，乙型肝炎 48%，人乳头瘤病毒 5%，和蜱传脑炎 6%。
尽管许多指南建议 IBD 患者接种疫苗，但疾病预防免疫接种仍经常被忽视，包括在瑞士，这增加了他们患疫苗可预防疾病的风险。应标准化血清学检测以监测患者在随访期间的保护作用，因为该人群的免疫力可能会更快减弱。
