An Australian Audit Of Vaccination Status In Children And Adolescents With Inflammatory Bowel Disease

Many immunization guidelines, including those in Australia, are also now recommending additional pneumococcal vaccine for special risk patients, including those with IBD on immunosuppressive medication [ 18 ]. The treating gastroenterologist is often the main source of immunization advice in childhood and adolescent IBD, particularly if immunosuppressive therapy is commenced. At RCH there is an Immunization Drop-in Centre open business hours, staffed by nurse immunization specialists, where queries can be directed and vaccines administered on the day of clinic appointments. In Victoria, immunization nurse specialist or primary care physicians administer the majority of vaccines. Table 1. Australian National Immunization Program (NIP) Schedule The primary aim of this study was to describe the compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD current at the time of the study [ 19 ]. A secondary aim was to review the serological screening for VPD in patients with IBD. Methods A multi-faceted retrospective review of immunization status was undertaken, with the inclusion criteria being age 0-18 years at diagnosis and on the IBD register. There were a total of nine gastroenterologists working across the two tertiary units [RCH and MMC] at the time of the study. Hospital records of all participants were audited, with any vaccinations administered recorded in the outpatient notes and/or a medication chart if administered at the RCH Immunization Drop-in-centre. A telephone interview survey was conducted with consenting parents using the parent-held child immunization record. The vaccination history was checked against the primary care physician and ACIR records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified. Therapies were categorized into four groups: ASA derivatives (sulphasalazine, osalazine, mesalazine and balsalazide); oral corticosteroids (prednisolone); immunosuppressive agents (azathioprine, methotrexate) and biologics (infliximab). The RCH patient’s hospital laboratory results were reviewed to identify if any baseline serological testing was performed to review the requirement for additional protection against VPD such as varicella and hepatitis B. Multiple sources were reviewed for any vaccine safety concerns or reports of adverse events following immunization, including: hospital records, general practitioner records and parent reports through interviews.

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