S3316 Vaccinations in the VA - A Quality Improvement Project to Improve Vaccination Rates in Patients With Inflammatory Bowel Disease on Immunomodulating Agents at a Mid-South VA Hospital

Abstract

Introduction: Many studies have shown patients with inflammatory bowel disease are at an increased risk for infections even prior to the side effects of immunomodulating agents. These agents have provided significant improvement in rates of symptom control for patient’s with IBD but have increased the risk of infections in this already vulnerable population. We attempted to assess and improve vaccination rates at a Veterans Affairs hospital in the Mid-South. Methods: We studied 254 patients at Memphis VA Medical Center with a diagnosis of Inflammatory Bowel disease. Of these 254 patients, 35 patients on TNF inhibitors as well as 20 on chronic steroids or Azathioprine/Mesalamine. Our methods included a 3-pronged approach: 1. Patients would be called to inform them of suggested vaccines 2. Flyers will be put up in the patient rooms and waiting room with information regarding Prevnar/Pneumovax/Flu/Heplisav-B/Shingrix vaccines and 3. Education material would be sent to GI providers regarding vaccination guidelines. Initial numbers were immediately prior to 1/2021 and repeat analysis would be completed on 1/2022 to allow time for completion of vaccinations requiring multiple doses as well as to accommodate for delays in the COVID vaccine. Results: Our goal was initially to increase vaccination rates for each of our vaccines (Prevnar, Pneumovax, Flu, Heplisav-B, Shingrix and COVID-19 by 15%. We have currently achieved our goal of increasing vaccination rates by 15% in all categories excluding flu as the flu season was finished by the time the project was underway. In our data analysis on 1/2022 we will include flu into our project measures. The exact increase in vaccination rates is still to be determined as patients are currently on the schedule to be vaccinated and the final percentages will be presented as data in the conference. Conclusion: Our project aimed to improve vaccination rates of patients with IBD on immunosuppression at the Memphis VA especially in the setting of the new COVID-19 immunization. The VA proved to be the optimal place for our study based on all vaccinations being available in the office as well as easily being able to track and establish follow-up as both PCP and GI follow-up were documented in one electronic medical record and the majority of patients following within the system. Our project and its successes hope to emphasize the drastic improvements a clinic can have by increasing awareness for both patients and providers regarding appropriate vaccinations.