A38 SUBOPTIMAL VACCINATION ADHERENCE IN MOTHERS WITH INFLAMMATORY BOWEL DISEASE AND THEIR BIOLOGIC-EXPOSED INFANTS

Abstract

Abstract Background Data suggests that postpartum IBD patients have low self-reported vaccine rates despite being exposed to multiple care providers. To date, there is limited data on vaccine safety in infants exposed to biologic therapies in utero for the treatment of maternal IBD, with only questionnaire style studies and one case report of a fatal outcome post BCG vaccine. This has led to guidelines recommending against live vaccines under 6 months, such as the rotavirus vaccine, in biologic exposed infants. Aims To assess vaccine compliance in mothers with IBD and their infants and evaluate rotavirus safety to help optimize preventative medicine and guide future vaccine recommendations. Methods We obtained data from the University of Calgary’s Pregnancy in IBD Registry from 2012 to 2018 and from provincial vaccination and personal health records. Vaccine rates for Hep-A, Hep-B, Pneu-C-13, Pneu-C-23 and DTap were obtained for 117 mothers who received biologic therapy during pregnancy. Rotavirus (n=74 as it was introduced in ‘14) and DTap-IPV-Hib, Men-C, Pneu-C-13 and MMR (n=117) rates were obtained for infants exposed to biologics in utero. Rotavirus (n=92) and non-rotavirus (n=142) rates for non-biologic exposed infants were also collected. Rotavirus complications, characterized by related emergency room visits, were obtained. Descriptive statistics were performed with chi-square tests. Results We found the following rates of vaccine uptake in the biologic treated mothers: Hep-A (47%), Pneu-C-13 (32%), Pneu-C-23 (36%), Hep-B (75%) and DTap (79%). When comparing biologic and non-biologic exposed infants there were high rates of compliance for recommended vaccines with no differences in DTap-IPV-Hib (91% vs. 89%, p=0.11), Men-C (96% vs. 92%, p=0.80), Pneu-C-13 (95% vs. 93%, p=0.14) and MMR (96% vs. 92%, p=0.80). There was a significant difference in rotavirus rates (20% vs. 87%, n < 0.0001) given the recommendation against vaccination in biologic exposed infants. There was a significant difference in vaccination guideline adherence within the biologic group when comparing inappropriately administered rotavirus vaccines with inappropriately missed recommended vaccines (20% vs. 6%, p=0.02). No infants who received the rotavirus vaccine suffered from intussusception or death nor was there a significant difference in adverse events between the two groups (20% vs 9%; p=0.71). Conclusions The study highlights the need for improved vaccination education and implementation given suboptimal vaccine adherence in biologic treated mothers and the inadvertent administration of the live rotavirus vaccine in their biologic exposed infants. The lack of rotavirus vaccine adverse events shows potential vaccine safety in biologic exposed infants and requires further study. Funding Agencies None