Vaccination recommendations and adherence in inflammatory bowel disease: A physician-patient discordance study

Abstract

Objective: Despite specific recommendations, immunization rates among patients with inflammatory bowel disease (IBD) remain suboptimal. This study aimed to assess vaccination management by exploring the concordance and discordance between physicians' reported vaccination recommendations and patients' recall of having received those recommendations, as well as patients' adherence following a medical recommendation.

Patients and methods: An anonymous online survey was sent to 8000 patients from a national patient association (ACCU Spain) and 1000 members of the Spanish IBD Working Group (GETECCU).

Results: A total of 144 physicians and 1302 patients responded (mean age of 43 years). Almost all physicians expressed concern about vaccination in IBD and 63% deemed them very important. Although 69% of physicians reported recommending influenza vaccination during pregnancy, only 11.1% of pregnant patients recalled having received such advice. Among patients who reported having received a vaccination recommendation, adherence varied widely by vaccine type, ranging from 55% for HPV to over 80% for influenza, pneumococcal, hepatitis B, and tetanus vaccines. The main reasons for non-adherence were the perception that vaccination was unnecessary and fear of adverse events.

Conclusions: Discordance exists between physicians' reported vaccination practices and patients' recall of the information received. Although physicians awareness is high, communication gaps and other barriers may limit effective implementation.

Keywords: Adherence; Adherencia; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Vaccination; Vacunación.