P101 INFLUENZA VACCINATION COVERAGE IN PEDIATRIC PATIENTS WITH INFLAMMATORY BOWEL DISEASE

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Children with chronic health conditions, including IBD, are at especially high risk for influenza infection and resulting complications. The Crohn’s & Colitis Foundation’s Top 10 Quality Process Indicators for IBD and American College of Gastroenterology’s clinical guidelines for preventative health maintenance recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients. We utilized longitudinal data (2001 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was diagnosis of IBD based upon ICD-9/10 diagnosis codes. The included subjects were eligible for SC Medicaid at least 9 months out of 12 each year and had no months of ineligibility occurring between October and May. Children with IBD were matched 1:4 to children without IBD on age and sex. Influenza vaccination coverage for IBD and non-IBD groups for each season were calculated as [# receiving vaccine] / [# eligible]. We calculated 95% confidence intervals for these estimates using 10,000 nonparametric bootstrap replications adjusted for clustering. A multivariable random effects logistic regression model was used to identify predictors of influenza vaccination. Overall, 1,184 IBD subjects and 4,736 matched non-IBD subjects were identified during the study period. Among the IBD patients, 698 were diagnosed with ulcerative colitis, 348 were diagnosed with Crohn’s disease, and 138 patients had diagnosis codes for both. The average age was 9.5 years and the majority of patients were male (52.7%). Among pediatric IBD patients, flu vaccine coverage increased from 2% in 2001 to 40% in 2016. For each year into the study, children had higher odds of obtaining a flu vaccine (OR=1.24, p<0.01). Compared to non-IBD subjects, children with IBD had higher odds of obtaining a flu vaccine (OR=1.22, p<0.001). Children residing in urban locations had higher odds of obtaining a flu vaccine (OR=1.56, p=0.001) compared to children from rural locations. Compared to white females, black females (OR=0.85, p=0.017) and black males (OR=0.84, p=0.012) had significantly lower odds of obtaining a flu vaccine. Children receiving corticosteroids had higher odds of obtaining a flu vaccine (OR=1.21, p<0.001) compared to children not receiving corticosteroids. Flu vaccination coverage for both pediatric IBD and non-IBD patients significantly increased from 2001 to 2016. IBD patients were more likely to get vaccinated compared to non-IBD patients, although vaccination coverage in SC remains below target levels. Efforts to increase influenza vaccination in pediatric IBD patients are needed.