Patients with IBD in ‘socially vulnerable’ communities less likely to be vaccinated
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DENVER — Socioeconomic status, household composition and housing or transportation were among predictors of low vaccination rates in patients with inflammatory bowel disease, according to a presenter at the Crohn’s and Colitis Congress.
“Despite an increased risk for infection, patients with IBD have low vaccination rates,” Jessica Sheehan, MD, a gastroenterology and hepatology fellow at the University of Michigan, told Healio. “Social determinants of health, such as socioeconomic status, housing and transportation, have an influence on health and health behaviors, but are often overlooked.”
Sheehan and colleagues used the social vulnerability index — a publicly available tool from the CDC — to examine the association between various social determinants of health and vaccination rates in individuals with IBD at the University of Michigan.
Researchers included 15,245 patients between January 2015 and August 2022, and used data in electronic medical records to determine corresponding social vulnerability indices, which were compared with patients’ vaccination status against influenza, COVID-19, pneumococcal pneumonia and zoster. Researchers reported high rates of unvaccinated individuals across all vaccine types (42.8%, 50.9%, 62.4% and 89.6%, respectively).
According to study results, high total levels of social vulnerability correlated with lower vaccination rates for influenza (–1.3; 95% CI, –1.5 to –1.2), COVID-19 (–0.99; 95% CI, –1.1 to –0.88), pneumonia (–0.21; 95% CI, –0.27 to –0.14) and zoster (–0.23; 95% CI, –0.27 to –0.19). Further, high scores in socioeconomic status, household composition and housing/transportation predicted vaccine uptake while minority status/language was not significant.
“IBD patients living in socially vulnerable neighborhoods were less likely to receive vaccinations against influenza, COVID-19, pneumococcal pneumonia and herpes zoster,” Sheehan told Healio. “Socioeconomic status and household composition — for example, homes with older adults or people with disabilities — were identified as particular determinants associated with lower rates of vaccination.”
She added: “We hope this work will bring awareness to clinicians of the potential role of social vulnerability in health outcomes and that this will drive further research to better understand the relationship between social vulnerability and IBD health.
“To really improve vaccine equity, we need to expand this research to more diverse populations and perform qualitative studies to better understand community level facilitators and barriers to vaccination.”
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Sheehan J, et al. Presentation 18: Socially vulnerable patients with inflammatory bowel disease are at increased risk for vaccine preventable illness. Presented at: Crohn’s and Colitis Congress; Jan. 19-21, 2023; Denver (hybrid meeting).
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