Introduction Inflammatory bowel disease patients receiving immunosuppressive therapy are at increased risk of vaccine-preventable infections, including influenza, pneumococcal disease and COVID-19. International guidelines strongly recommend routine immunization in this vulnerable population, yet real-world vaccine adherence remains inconsistent.
Introduction
Inflammatory bowel disease patients receiving immunosuppressive therapy are at increased risk of vaccine-preventable infections, including influenza, pneumococcal disease and COVID-19. International guidelines strongly recommend routine immunization in this vulnerable population, yet real-world vaccine adherence remains inconsistent.
Problem Statement
The COVID-19 pandemic has intensified vaccine hesitancy and misinformation, potentially worsening already suboptimal vaccination uptake in patients with IBD. Limited data exist regarding post-pandemic adherence patterns and barriers to immunization among immunosuppressed IBD populations.
Summary
This cross-sectional observational study demonstrated persistently low vaccination adherence among immunosuppressed patients with IBD in the post-pandemic era. Fewer than one-quarter of patients were fully vaccinated according to recommended schedules for pneumococcal, influenza and SARS-CoV-2 vaccines. Uptake was particularly poor for pneumococcal vaccination and COVID-19 booster doses, despite the heightened infection risk associated with immunosuppressive therapy. Importantly, healthcare professional–led counselling emerged as one of the strongest predictors of vaccine adherence, with patients receiving direct vaccine recommendations significantly more likely to complete immunization schedules. Older age was also associated with better vaccine uptake, suggesting younger patients may represent a particularly vulnerable group for vaccine hesitancy and misinformation. Commonly reported barriers included uncertainty regarding vaccine necessity, concerns about safety and lack of awareness regarding vaccine recommendations. Alarmingly, more than 40% of patients reported inadequate counselling before initiation of immunosuppressive therapy, highlighting major deficiencies in preventive care pathways. The study also demonstrated inconsistent delivery of vaccine recommendations across different vaccines, particularly for shingles vaccination. These findings reinforce the critical role of gastroenterologists, IBD nurses, pharmacists and primary care providers in proactively addressing vaccine education and preventive healthcare during routine IBD management. Overall, the study highlights an urgent need for structured vaccination pathways, standardized counselling protocols and multidisciplinary preventive care strategies to improve immunization adherence in immunosuppressed IBD populations.
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