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Herpes zoster vaccination rates low among patients with IBD
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Vaccination rates for the herpes zoster virus are low among patients with inflammatory bowel disease despite an increased risk among this population, according to research published in Inflammatory Bowel Diseases.
In a retrospective study of patients in the Veterans Affairs Healthcare system, Nabeel Khan, MD, of the section of gastroenterology at the Corporal Michael J. Crescenz VA Medical Center, and colleagues found that patients with IBD have a higher risk for developing herpes zoster even if they are not exposed to immunosuppressant therapy. Also concerning, they said, was that patients with comorbidities and higher risk were even less likely to be vaccinated.
“Sicker patients and those with fewer medical visits were less likely to be vaccinated,” they wrote. “Thus, patients who are the highest risk of getting [herpes zoster] were less likely to get immunized.”
Khan and colleagues analyzed data from a cohort of 18,825 patients aged at least 60 years at the time the herpes zoster vaccine was introduced in 2006. Most current guidelines recommend vaccination at age 60. However, the ACG recommends vaccination at age 50 for patients with IBD because of their increased risk.
Of those eligible for vaccination between 2006 and 2016, just 3,946 (20.96%) were vaccinated at any point during their follow-up. Additionally, researchers found that only 59 patients were immunized the first year the vaccine was available, and 11.7% of the eligible population was vaccinated in the first 5 years of follow-up.
Patients who had been exposed to steroids, thiopurines or anti-TNF medications were less likely to be vaccinated, as were older patients and patients with higher comorbidity index, according to the study.
Khan and colleagues wrote that these low vaccination rates could be due to knowledge gap among both patients and their doctors.
“Lack of knowledge has led to many clinicians and patients believing that vaccination may exacerbate IBD disease activity, which is reflected as low vaccination rates in IBD patients,” they wrote, adding it could also be caused by a misunderstanding about which physicians should be administering the vaccine.
“Many gastroenterologists still feel it is the duty of the primary care providers to vaccinate IBD patients,” Khan and colleagues wrote. “The frequency of [herpes zoster] vaccination could be increased if gastroenterologists were to make specific recommendations to primary care providers about the need to immunize patients with IBD with the new [herpes zoster] vaccine.” – by Alex Young
Disclosures: Khan reports financial ties to Pfizer, Luitpold and Takeda Pharmaceuticals. Please see the full study for all other authors’ relevant financial disclosures.
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