W1202 Influenza Vaccination Awareness and History in Children with Inflammatory Bowel Disease

Abstract

BACKGROUND: The Public Health Agency of Canada recommends annual influenza vaccination for all individuals with chronic immunosuppression (due to underlying disease and/or therapy) as well as household contacts. OBJECTIVES: To evaluate awareness of influenza vaccine recommendations, and personal and family history of influenza vaccination in children with inflammatory bowel disease (IBD). METHODS: Medical care for all children with IBD in southern Alberta (population 1.5 million) is provided at the only tertiary-care center for this region, the Alberta Children's Hospital (ACH). All children with IBD followed at the ACH were invited to participate in a study on influenza vaccine immunogenicity. All participants completed a parent/self-administered questionnaire on awareness of influenza vaccine recommendations and personal and family history of influenza vaccination. Data on demographics, IBD history, and IBD medications were also collected. RESULTS: Sixtyone children with IBD and their families participated in the influenza vaccine immunogenicity study and completed the questionnaire. Thirty-seven and 31 families were aware of influenza vaccine recommendations in immunosuppressed individuals and household contacts, respectively. Thirty-one subjects with IBD had previous influenza vaccination; however 4 subjects had not received any influenza vaccinations in the last 4 years. IBD subjects who were aware of recommendations were more likely to have previous influenza vaccination (odds ratio [OR] 6.4; 95% confidence interval [CI] 2.0-20.7). The reasons for no previous influenza vaccination in subjects with IBD were: no specific reason (13), “didn't know needed it” (11), needle aversion (4), did not believe vaccine effective (3), afraid of side effects (2), vaccine not available (1), and personal philosophy against vaccine (1). Subjects with disease duration ≥ 1 year were more likely to be aware of recommendations (OR 3.6; 95% CI 1.211.1) and have previous vaccination (OR 5.9; 95% CI 1.6-17.4). No association was found between immunosuppressive medication use and awareness of recommendations or previous vaccination. Families aware of recommendations for household contacts were more likely to have previous influenza vaccinations in siblings (OR 7.9; 95% CI 2.3-27.0) and parents (OR 3.0; 95% CI 0.8-11.3). CONCLUSIONS: Families of children with IBD have suboptimal awareness and uptake of influenza vaccination. Physicians prescribing immunosuppressive medications for IBD need to discuss vaccination for vaccine-preventable diseases, especially influenza, with their patients.