Vaccination rate and immunity of children and adolescents with inflammatory bowel disease or autoimmune hepatitis in Germany

Teresa Seitel · Sarah Ehrenberg · Klára Frivolt · Andreas Krahl · Elke Lainka · Patrick Gerner +9 more

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Vaccine Coverage and Hesitancy Inflammatory Bowel Disease Immunodeficiency and Autoimmune Disorders

Abstract

BACKGROUND AND AIMS: Immunosuppressed patients are at risk of severe infections with vaccination preventable diseases. We evaluated vaccination rate and immunity of children and adolescents with inflammatory bowel disease (IBD) and autoimmune hepatitis (AIH). METHODS: Immunization rate of 329 children with IBD (n = 300) and AIH (n = 29) was assessed in seven German centres using vaccination certificates, history of chicken pox and by determining anti-varicella zoster virus (VZV) and anti-measles IgG antibodies. RESULTS: Of the total cohort 86% received long-term immunosuppression. Four doses of a hexavalent vaccine were documented in 89%, at least one dose of measles, mumps, and rubella (MMR) vaccination was documented in 325 (99%), with 300 (92%) receiving two doses. Anti-measles IgG concentrations were insufficient in 11% of the immunized patients. VZV vaccination was officially recommended in Germany since 2004, and implemented in 88% born from 2005 onwards. In patients born earlier VZV catch up vaccination only reached 25% (n = 67). Of 118 patients with documented VZV vaccination 25 (21%) did not display sufficient anti-VZV IgG. Of 198 patients with a history of chicken pox, six had undetectable anti-VZV IgG. Of 29 patients having neither had chicken pox nor VZV vaccination, 20 were found to have sufficient anti-VZV IgG. CONCLUSIONS: In our cohort vaccination coverage for hexavalent and MMR vaccinations was good, but insufficient for VZV vaccination in patients born before 2005. Neither the vaccination certificate nor the history of chicken pox is reliable to predict VZV immunity indicating a need for serologic investigations and if needed vaccination before initiating immunosuppressive therapy.

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References

2006Patients with Inflammatory Bowel Disease Are at Risk for Vaccine-Preventable Illnesses 2011Vaccinating the inflammatory bowel disease patient: Deficiencies in gastroenterologists knowledge 2013A Quality Improvement Project Significantly Increased the Vaccination Rate for Immunosuppressed Patients with IBD 2011Vaccination Coverage in Immunosuppressed Patients 2011The immunization status of patients with IBD is alarmingly poor before the introduction of specific guidelines 2019Empfehlungen der Ständigen Impfkommission (STIKO) beim Robert Koch-Institut – 2018/2019 2011An australian audit of vaccination status in children and adolescents with inflammatory bowel disease 2018Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2016

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2020Vaccination Rates and Family Barriers Among Children with Inflammatory Bowel Disease

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