P799 Frequency of vaccination for herpes zoster (HZ) among inflammatory bowel disease (IBD) patients

Abstract

Patients with Inflammatory bowel disease (IBD), especially those on immunosuppressive medications have an increased risk of developing Herpes Zoster (HZ). To prevent this complication it is recommended that everybody irrespective of IBD should get immunised. Although the age at which immunisation should be administered is variable among different societies, they all agree that by the age of 60 all patients, irrespective of IBD status should be immunised. Our aim was to evaluate the proportion of patients with IBD who are vaccinated for HZ. We used the Veterans Affairs (VA) database for our study as it is the largest integrated healthcare system in the USA and patients do not have to pay for vaccinations. The study period was from January 1, 2000, through June 30, 2016. Follow-up started at age 60 if they were already diagnosed with IBD or age at diagnosis of IBD if the onset of disease was after age 60. Follow-up ended if they got vaccinated, developed herpes, died, were lost to follow-up or end of the study period whichever was first. Baseline demographic characteristics at the time of start of follow-up were determined. Vaccination for HZ and development of herpes was identified by CPT and ICD 9 and 10 codes and were internally validated. There were 40496 patients in our cohort who met the inclusion criteria. 90.9 % were male. Over the follow-up period, a total of 7370 of patients were vaccinated. This translated into a vaccination rate of 18.2%. The follow-up period was 358976.83 years for the entire cohort. While evaluating the age at which patients got vaccinated, instead of there being a large segment being vaccinated close to age 60 there was a steady annual increment. After the age of 70, 3436 (46.6%) patients got vaccinated (Images 1 and 2). Despite HZ vaccine being recommended and covered in the VA system for patients above age 60, only 18.2% of patients above this age were vaccinated and those who did get vaccinated got so at various time intervals after the age of 60. Greater efforts need to be made towards the further adoption of vaccination especially in view of the approval of a new potentially safer and more effective vaccine.