Vaccination Rates and Family Barriers Among Children with Inflammatory Bowel Disease

BACKGROUND: Many children with inflammatory bowel disease (IBD) are taking immunosuppressant medications that place them at risk for vaccine preventable diseases. Despite national guidelines, children with IBD have low vaccination rates. Adult data suggest that there is concern about the safety of vaccines. There are no current studies addressing perceived safety about vaccinations among families of children with IBD. METHODS: A total of 108 caregivers of children (ages 10–25 years) were surveyed during their outpatient visit, with approximately half having a diagnosis of IBD. The survey consisted of validated questions regarding vaccine safety and opinions. After enrollment, state-wide vaccine registry data was collected. Demographics between the 2 groups were compared using chi-square and the Wilcoxon rank-sum tests to analyze Likert-scale questions. RESULTS: The majority of children followed for IBD were Caucasian males, had Crohn disease (68%), and were immunosuppressed. Results from the survey revealed a concern about vaccine safety (40% vs 16%, P = 0.03) and overall effectiveness (34% vs 12%, P < 0.01) in the IBD group compared with the non-IBD. Furthermore, more IBD families were worried that vaccines would worsen their child’s symptoms (36% vs 10%, P ≤ 0.01). The majority of children were missing the flu and/or human papilloma virus vaccine. Finally, 96% of the children on a biologic for their IBD were missing the PPSV23 booster. CONCLUSIONS: Caregivers of children with IBD are more concerned about vaccine safety and effectiveness than those with non-IBD diagnosis. Despite being on immunosuppressant medications, many patients were missing recommended vaccines.