Academic Rheumatology, University of Nottingham, Nottingham, UK
Nottingham NIHR BRC, Nottingham, UK.
BMJ Open Gastroenterol. 2024 Jun 18;11(1):e001370. doi: 10.1136/bmjgast-2024-001370.
To investigate (1) the UK-wide inactivated influenza vaccine (IIV) uptake in adults with inflammatory bowel disease (IBD), (2) the association between vaccination against influenza and IBD flare and (3) the effectiveness of IIV in preventing morbidity and mortality.
Data for adults with IBD diagnosed before the 1 September 2018 were extracted from the Clinical Practice Research Datalink Gold. We calculated the proportion of people vaccinated against seasonal influenza in the 2018-2019 influenza cycle. To investigate vaccine effectiveness, we calculated the propensity score (PS) for vaccination and conducted Cox proportional hazard regression with inverse-probability treatment weighting on PS. We employed self-controlled case series analysis to investigate the association between vaccination and IBD flare.
Data for 13 631 people with IBD (50.4% male, mean age 52.9 years) were included. Fifty percent were vaccinated during the influenza cycle, while 32.1% were vaccinated on time, that is, before the seasonal influenza virus circulated in the community. IIV was associated with reduced all-cause mortality (aHR (95% CI): 0.73 (0.55,0.97) but not hospitalisation for pneumonia (aHR (95% CI) 0.52 (0.20-1.37), including in the influenza active period (aHR (95% CI) 0.48 (0.18-1.27)). Administration of the IIV was not associated with IBD flare.
The uptake of influenza vaccine was low in people with IBD, and the majority were not vaccinated before influenza virus circulated in the community. Vaccination with the IIV was not associated with IBD flare. These findings add to the evidence to promote vaccination against influenza in people with IBD.
（1）调查英国范围内患有炎症性肠病（IBD）的成年人对灭活流感疫苗（IIV）的接种情况，（2）评估流感疫苗接种与 IBD 发作之间的关联，以及（3）评估 IIV 预防发病率和死亡率的效果。
从临床实践研究数据链接黄金（Clinical Practice Research Datalink Gold）中提取了 2018 年 9 月 1 日前确诊的 IBD 成年患者的数据。我们计算了在 2018-2019 流感周期中接种季节性流感疫苗的人群比例。为了调查疫苗的有效性，我们计算了接种疫苗的倾向评分（PS），并对 PS 进行了逆概率治疗加权的 Cox 比例风险回归。我们采用自对照病例系列分析来调查疫苗接种与 IBD 发作之间的关联。
共纳入 13631 名 IBD 患者（50.4%为男性，平均年龄为 52.9 岁）的数据。50%的患者在流感周期内接种了疫苗，而 32.1%的患者按时接种了疫苗，即在社区流感病毒流行之前。IIV 与全因死亡率降低相关（调整后 HR（95%CI）：0.73（0.55，0.97），但与肺炎住院无关（调整后 HR（95%CI）0.52（0.20-1.37），包括流感活跃期（调整后 HR（95%CI）0.48（0.18-1.27））。接种 IIV 与 IBD 发作无关。
IBD 患者接种流感疫苗的比例较低，且大多数患者在社区流感病毒流行之前未接种疫苗。接种 IIV 与 IBD 发作无关。这些发现为在 IBD 患者中推广流感疫苗接种提供了更多证据。
