Crohn’s & Colitis Congress™

Sessions Speakers Exhibitors Floor Plan Buzz

P202 - VACCINATIONS IN IBD PATIENTS: GASTROENTEROLOGISTS’ VS. INTERNISTS’ PRACTICE AND PERCEPTIONS OF RESPONSIBILITY (Room Poster Hall)

IBD patients (pts) are at increased risk of vaccination-preventable infections. It is not clear whether the gastroenterologists (GI) or primary care providers (PP) assume responsibility for vaccination. We anonymously surveyed 94 internists (IM) & 50 GI who are affiliates or trainees of St. Louis University, using electronic or paper self-administered instruments. 50 GI & 87 IM responded. GI & IM were similar in indicating that PP (64 vs 74%) or GIs (34 vs 23%) should order vaccines & in being comfortable providing activated (58 vs 56%) or inactivated vaccines (92 vs 84%). GI were less likely to indicate that PP should document vaccination status (38 vs 82%, 95% confidence interval on difference (CI) 26%-59%) & that PPs should determine when/which vaccines are given (28 vs 59%, CI 12%-46%) & more likely to indicate that GI should document vaccination status (58 vs16%, CI 24%-57%). GI were more likely to report providing HAV vaccine (60 vs 39%, CI 2%-38%), HBV vaccine (86 vs 56%, CI 13%-43%), & vaccination prior to immune suppression (70 vs 51%, CI 1%-36%). They were less likely to report providing pertussis (14 vs 44%, CI 13%-43%), zoster (38 vs 64%, CI 8%-43%), & diphtheria (20 vs 48%, CI 11%-43%) vaccines, inactivated influenza vaccine to immune suppressed pts (66 vs 84%, CI 2%-34%), & PSV13 followed by PSV23 & 5-yr boosters to immune suppressed pts (27% vs 62%, CI 17%-50%). There were no significant differences between the two groups in counseling immune suppressed pts’ households to avoid live influenza vaccines, handling diapers of rotavirus-vaccinated infants for up to 4 wks, & providing zoster/varicella vaccination in different clinical scenarios. The data indicates important differences & deficiencies in managing vaccination of IBD pts by GI & IM. This may be due in part to differences in their perceptions of responsibility. Uniform & clear vaccination guidelines & better cooperation may be required for effective & efficient management of IBD pts.