Payne Kaitlin, Jansson-Knodell Claire, Trommer Emily, Ford Andrew, Weekley Kendra, Gardinier David, Rubio-Tapia Alberto
Division of Gastroenterology and Hepatology, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
Celiac Disease Program, Gastroenterology, Hepatology, and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Dig Dis Sci. 2025 Sep 4. doi: 10.1007/s10620-025-09350-y.
Patients with celiac disease (CeD) are at increased risk of pneumococcal infections, and guidelines recommend vaccination against pneumococcal disease as a safe and effective strategy at reducing the risk of infection. The rate of vaccination amongst patients with CeD is unknown. The aim of this study was to evaluate current underlying vaccination rates and to improve vaccination rates through a quality improvement initiative.
Data regarding rates of pneumococcal vaccination amongst patients with biopsy-confirmed CeD were retrospectively collected. A prospective quality improvement initiative was then performed. An educational handout was provided to patients seen during in-person clinic visits, and the pneumococcal conjugate 20 vaccine (PCV20) was offered.
A total of 340 patients were initially reviewed. Only 78 patients (21%) were adequately vaccinated against pneumococcal infection. In the prospective portion, 93 CeD patients were seen in the office during the period of intervention, 33 of whom were already vaccinated (35%). The handout was given to 42/60 eligible patients, the majority of whom were vaccinated during the same clinic visit (62%). Of patients who did not receive the flier, 2/18 were vaccinated in the office. Patients were significantly more likely to get vaccinated after receiving the handout (odds ratio (OR) 13.0; 95% CI 2.6-64.2; p = 0.0016).
Patients with CeD are under-vaccinated against pneumococcal disease. Providing educational resources and administering PCV20 during in-person GI office visits appears to be an effective strategy to increase vaccination rates.
乳糜泻（CeD）患者感染肺炎球菌的风险增加，指南推荐接种肺炎球菌疾病疫苗，作为降低感染风险的安全有效策略。CeD患者的疫苗接种率尚不清楚。本研究的目的是评估当前的基础疫苗接种率，并通过质量改进举措提高疫苗接种率。
回顾性收集经活检确诊的CeD患者的肺炎球菌疫苗接种率数据。然后开展一项前瞻性质量改进举措。为门诊就诊的患者提供一份教育手册，并提供20价肺炎球菌结合疫苗（PCV20）。
最初共纳入340例患者进行评估。只有78例患者（21%）接种了足够剂量的肺炎球菌疫苗。在前瞻性研究阶段，干预期间有93例CeD患者到门诊就诊，其中33例（35%）已接种疫苗。42/6例符合条件的患者收到了手册，其中大多数在同一门诊就诊期间接种了疫苗（62%）。未收到手册的患者中，2/18例在门诊接种了疫苗。患者在收到手册后接种疫苗的可能性显著增加（优势比（OR）为13.0；95%置信区间为2.6 - 64.2；p = 0.0016）。
CeD患者肺炎球菌疾病疫苗接种不足。在胃肠科门诊就诊时提供教育资源并接种PCV20似乎是提高疫苗接种率的有效策略。
