Wasan SK. Inflamm Bowel Dis. 2011;doi:10.1002/ibd.21667.
Gastroenterologists’ had poor knowledge of
appropriate immunizations for their patients with inflammatory bowel disease.
Researchers, therefore, suggest for educational programs to ensure that these
patients receive recommended vaccinations.
“Gastroenterologists need to do a better job of
recommending the appropriate vaccinations to their inflammatory bowel disease
(IBD) patients, as their immunosuppressive medications put them at higher risk
for acquiring infections that could be prevented,” Sharmeel K. Wasan,
MD, of the gastroenterology section at the Boston Medical Center, told
Infectious Disease News. “Simply increasing awareness that
gastroenterologists are doing a poor job of vaccinating their IBD patients will
serve as a first step in improving the recommendations that they make.”
Wasan and colleagues assessed the knowledge of
recommended vaccinations in patients with IBD among 108 randomly selected
gastroenterologists from the American College of Gastroenterology. Participants
were asked to complete an electronic survey that included questions about the
suitable vaccinations for the immunocompetent and immunosuppressed patient with
IBD; barriers to vaccine recommendations; and the perceived role of the
gastroenterologist vs. the primary care physician.
Forty gastroenterologists reported management of fewer
than 40 patients with IBD and 68 reported management of more than 40 patients
with IBD. Overall, 52% of those surveyed said they requested immunization
history from their patients either all or most of the time.
Compared with 67.5% of academic physicians who were more
likely to inquire about immunization history most or all of the time, only
42.4% of private practice physicians inquired about immunization history
(P=.01). Fifteen percent of gastroenterologists said they did not
regularly recommend influenza immunization because they were too busy or
forgot; had no specific reason; or they did not know the patient needed
Further, 64% said the PCP was responsible for
determining which vaccinations to administer, and 83% said the PCP was
responsible for administering the vaccine.
Only 66% of gastroenterologists reported recommending
the human papillomavirus vaccine to immunocompetent patients with IBD, and only
47% recommended the vaccine to immunosuppressed patients.
“Gastroenterologists who care for IBD patients are
the most qualified clinician to anticipate future need for immunosuppressive
therapy (even if none are being prescribed presently), and consider the
capacity for an appropriate serologic response to vaccination,” the
researchers wrote. “We do not imply that the gastroenterologist needs to
administer vaccinations, but rather they need to make explicit recommendations
to the PCP regarding the needed vaccinations.”
Disclosure: Dr. Wasan reports no relevant financial disclosures.