Vaccination coverage in immunosuppressed patients: results of a regional health services research study.
Identifieur interne : 000275 ( Main/Exploration ); précédent : 000274; suivant : 000276Vaccination coverage in immunosuppressed patients: results of a regional health services research study.
Auteurs : Niels Teich [Allemagne] ; Tobias Klugmann ; Astrid Tiedemann ; Babett Holler ; Joachim Mössner ; Anke Liebetrau ; Ingolf SchiefkeSource :
- Deutsches Arzteblatt international [ 1866-0452 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Allemagne (épidémiologie), Facteurs de risque, Femelle, Humains, Maladie de Crohn (), Maladie de Crohn (épidémiologie), Mâle, Rectocolite hémorragique (), Rectocolite hémorragique (immunologie), Rectocolite hémorragique (épidémiologie), Résultat thérapeutique, Sujet immunodéprimé (immunologie), Vaccination (), Évaluation des risques.
- MESH :
- immunologie : Rectocolite hémorragique, Sujet immunodéprimé.
- épidémiologie : Allemagne, Maladie de Crohn, Rectocolite hémorragique.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Maladie de Crohn, Mâle, Rectocolite hémorragique, Résultat thérapeutique, Vaccination, Évaluation des risques.
English descriptors
- KwdEn :
- Adult, Colitis, Ulcerative (epidemiology), Colitis, Ulcerative (immunology), Colitis, Ulcerative (prevention & control), Crohn Disease (epidemiology), Crohn Disease (prevention & control), Female, Germany (epidemiology), Humans, Immunocompromised Host (immunology), Male, Middle Aged, Risk Assessment, Risk Factors, Treatment Outcome, Vaccination (statistics & numerical data).
- MESH :
- epidemiology : Colitis, Ulcerative, Crohn Disease, Germany.
- immunology : Colitis, Ulcerative, Immunocompromised Host.
- prevention & control : Colitis, Ulcerative, Crohn Disease.
- statistics & numerical data : Vaccination.
- Adult, Female, Humans, Male, Middle Aged, Risk Assessment, Risk Factors, Treatment Outcome.
Abstract
BACKGROUND
Patients with chronic inflammatory diseases are at elevated risk of infections that can be prevented by vaccination. This elevated risk is due not just to these patients' primary illnesses, but also to the immunosuppressive treatment that they often receive. We studied the vaccination rate in a random sample of patients with two types of inflammatory bowel disease (IBD), namely, Crohn's disease and ulcerative colitis. In particular, we asked unvaccinated patients why they had re-fused the vaccine.
METHODS
From April to September 2009, we gave a 38-item questionnaire to 203 consecutive patients with IBD (57% with Crohn's disease, 63% female, median age 36 years) who had not received vaccination counseling for at least one year, and inspected the patients' vaccination cards. We compared the findings to the current recommendations of the German Federal Standing Committee on Vaccination (Ständige Impfkommission).
RESULTS
83% of the patients had a vaccination card. Substantial deficiencies in vaccination were found. Only 67% of the patients had been immunized against tetanus in the previous 10 years, and only 21% against pertussis. Only 28% were vaccinated against seasonal influenza in 2008, and only 9% had ever received anti-pneumococcal vaccine. A subgroup analysis in which we compared 39 patients taking TNF-blockers to 67 patients who never had any type of immunosuppressive treatment revealed no difference in vaccination rates. 80% of all patients said they were willing to receive all of the officially recommended vaccinations. 22% of all patients said they avoided vaccinations for fear of side effects, while 15% said they did so because their immune system was supposedly "not intact", and 9% because they feared vaccination would worsen their IBD.
CONCLUSION
In this random sample, the vaccination rate fell far behind the recommendations. In particular, there was a marked discrepancy between patients' willingness to be vaccinated and the actual provision of vaccination. These findings imply that physicians need to be more aware of the possibly inadequate vaccination state of their immunosuppressed patients.
DOI: 10.3238/arztebl.2011.0105
PubMed: 21412507
Affiliations:
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last="Mössner">Joachim Mössner</name></author><author><name sortKey="Liebetrau, Anke" sort="Liebetrau, Anke" uniqKey="Liebetrau A" first="Anke" last="Liebetrau">Anke Liebetrau</name></author><author><name sortKey="Schiefke, Ingolf" sort="Schiefke, Ingolf" uniqKey="Schiefke I" first="Ingolf" last="Schiefke">Ingolf Schiefke</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21412507</idno><idno type="pmid">21412507</idno><idno type="doi">10.3238/arztebl.2011.0105</idno><idno type="wicri:Area/Main/Corpus">000290</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000290</idno><idno type="wicri:Area/Main/Curation">000290</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000290</idno><idno type="wicri:Area/Main/Exploration">000290</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Vaccination coverage in immunosuppressed patients: results of a regional health services research study.</title><author><name sortKey="Teich, Niels" sort="Teich, Niels" uniqKey="Teich N" first="Niels" last="Teich">Niels Teich</name><affiliation wicri:level="1"><nlm:affiliation>teich@lgvs.de</nlm:affiliation><country wicri:rule="url">Allemagne</country></affiliation></author><author><name sortKey="Klugmann, Tobias" sort="Klugmann, Tobias" uniqKey="Klugmann T" first="Tobias" last="Klugmann">Tobias Klugmann</name></author><author><name sortKey="Tiedemann, Astrid" sort="Tiedemann, Astrid" uniqKey="Tiedemann A" first="Astrid" last="Tiedemann">Astrid Tiedemann</name></author><author><name sortKey="Holler, Babett" sort="Holler, Babett" uniqKey="Holler B" first="Babett" last="Holler">Babett Holler</name></author><author><name sortKey="Mossner, Joachim" sort="Mossner, Joachim" uniqKey="Mossner J" first="Joachim" last="Mössner">Joachim Mössner</name></author><author><name sortKey="Liebetrau, Anke" sort="Liebetrau, Anke" uniqKey="Liebetrau A" first="Anke" last="Liebetrau">Anke Liebetrau</name></author><author><name sortKey="Schiefke, Ingolf" sort="Schiefke, Ingolf" uniqKey="Schiefke I" first="Ingolf" last="Schiefke">Ingolf Schiefke</name></author></analytic><series><title level="j">Deutsches Arzteblatt international</title><idno type="eISSN">1866-0452</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Colitis, Ulcerative (epidemiology)</term><term>Colitis, Ulcerative (immunology)</term><term>Colitis, Ulcerative (prevention & control)</term><term>Crohn Disease (epidemiology)</term><term>Crohn Disease (prevention & control)</term><term>Female</term><term>Germany (epidemiology)</term><term>Humans</term><term>Immunocompromised Host (immunology)</term><term>Male</term><term>Middle Aged</term><term>Risk Assessment</term><term>Risk Factors</term><term>Treatment Outcome</term><term>Vaccination (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Allemagne (épidémiologie)</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Maladie de Crohn ()</term><term>Maladie de Crohn (épidémiologie)</term><term>Mâle</term><term>Rectocolite hémorragique ()</term><term>Rectocolite hémorragique (immunologie)</term><term>Rectocolite hémorragique (épidémiologie)</term><term>Résultat thérapeutique</term><term>Sujet immunodéprimé (immunologie)</term><term>Vaccination ()</term><term>Évaluation des risques</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Colitis, Ulcerative</term><term>Crohn Disease</term><term>Germany</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Rectocolite hémorragique</term><term>Sujet immunodéprimé</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Colitis, Ulcerative</term><term>Immunocompromised Host</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Colitis, Ulcerative</term><term>Crohn Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Maladie de Crohn</term><term>Rectocolite hémorragique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Risk Assessment</term><term>Risk Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Maladie de Crohn</term><term>Mâle</term><term>Rectocolite hémorragique</term><term>Résultat thérapeutique</term><term>Vaccination</term><term>Évaluation des risques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Patients with chronic inflammatory diseases are at elevated risk of infections that can be prevented by vaccination. This elevated risk is due not just to these patients' primary illnesses, but also to the immunosuppressive treatment that they often receive. We studied the vaccination rate in a random sample of patients with two types of inflammatory bowel disease (IBD), namely, Crohn's disease and ulcerative colitis. In particular, we asked unvaccinated patients why they had re-fused the vaccine.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>From April to September 2009, we gave a 38-item questionnaire to 203 consecutive patients with IBD (57% with Crohn's disease, 63% female, median age 36 years) who had not received vaccination counseling for at least one year, and inspected the patients' vaccination cards. We compared the findings to the current recommendations of the German Federal Standing Committee on Vaccination (Ständige Impfkommission).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>83% of the patients had a vaccination card. Substantial deficiencies in vaccination were found. Only 67% of the patients had been immunized against tetanus in the previous 10 years, and only 21% against pertussis. Only 28% were vaccinated against seasonal influenza in 2008, and only 9% had ever received anti-pneumococcal vaccine. A subgroup analysis in which we compared 39 patients taking TNF-blockers to 67 patients who never had any type of immunosuppressive treatment revealed no difference in vaccination rates. 80% of all patients said they were willing to receive all of the officially recommended vaccinations. 22% of all patients said they avoided vaccinations for fear of side effects, while 15% said they did so because their immune system was supposedly "not intact", and 9% because they feared vaccination would worsen their IBD.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>In this random sample, the vaccination rate fell far behind the recommendations. In particular, there was a marked discrepancy between patients' willingness to be vaccinated and the actual provision of vaccination. These findings imply that physicians need to be more aware of the possibly inadequate vaccination state of their immunosuppressed patients.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21412507</PMID><DateCompleted><Year>2011</Year><Month>08</Month><Day>16</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1866-0452</ISSN><JournalIssue CitedMedium="Internet"><Volume>108</Volume><Issue>7</Issue><PubDate><Year>2011</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Deutsches Arzteblatt international</Title><ISOAbbreviation>Dtsch Arztebl Int</ISOAbbreviation></Journal><ArticleTitle>Vaccination coverage in immunosuppressed patients: results of a regional health services research study.</ArticleTitle><Pagination><MedlinePgn>105-11</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3238/arztebl.2011.0105</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Patients with chronic inflammatory diseases are at elevated risk of infections that can be prevented by vaccination. This elevated risk is due not just to these patients' primary illnesses, but also to the immunosuppressive treatment that they often receive. We studied the vaccination rate in a random sample of patients with two types of inflammatory bowel disease (IBD), namely, Crohn's disease and ulcerative colitis. In particular, we asked unvaccinated patients why they had re-fused the vaccine.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">From April to September 2009, we gave a 38-item questionnaire to 203 consecutive patients with IBD (57% with Crohn's disease, 63% female, median age 36 years) who had not received vaccination counseling for at least one year, and inspected the patients' vaccination cards. We compared the findings to the current recommendations of the German Federal Standing Committee on Vaccination (Ständige Impfkommission).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">83% of the patients had a vaccination card. Substantial deficiencies in vaccination were found. Only 67% of the patients had been immunized against tetanus in the previous 10 years, and only 21% against pertussis. Only 28% were vaccinated against seasonal influenza in 2008, and only 9% had ever received anti-pneumococcal vaccine. A subgroup analysis in which we compared 39 patients taking TNF-blockers to 67 patients who never had any type of immunosuppressive treatment revealed no difference in vaccination rates. 80% of all patients said they were willing to receive all of the officially recommended vaccinations. 22% of all patients said they avoided vaccinations for fear of side effects, while 15% said they did so because their immune system was supposedly "not intact", and 9% because they feared vaccination would worsen their IBD.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">In this random sample, the vaccination rate fell far behind the recommendations. In particular, there was a marked discrepancy between patients' willingness to be vaccinated and the actual provision of vaccination. These findings imply that physicians need to be more aware of the possibly inadequate vaccination state of their immunosuppressed patients.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Teich</LastName><ForeName>Niels</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>teich@lgvs.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klugmann</LastName><ForeName>Tobias</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Tiedemann</LastName><ForeName>Astrid</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Holler</LastName><ForeName>Babett</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Mössner</LastName><ForeName>Joachim</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Liebetrau</LastName><ForeName>Anke</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Schiefke</LastName><ForeName>Ingolf</ForeName><Initials>I</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>02</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Dtsch Arztebl Int</MedlineTA><NlmUniqueID>101475967</NlmUniqueID><ISSNLinking>1866-0452</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Dtsch Arztebl Int. 2011 Dec;108(49):836; author reply 837-8</RefSource><PMID Version="1">22238556</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Dtsch Arztebl Int. 2011 Dec;108(49):836-7; author reply 837-8</RefSource><PMID Version="1">22238557</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Dtsch Arztebl Int. 2011 Dec;108(49):837; author reply 837-8</RefSource><PMID Version="1">22238558</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003093" MajorTopicYN="N">Colitis, Ulcerative</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003424" MajorTopicYN="N">Crohn Disease</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016867" MajorTopicYN="N">Immunocompromised Host</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018570" MajorTopicYN="N">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment 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last="Klugmann">Tobias Klugmann</name><name sortKey="Liebetrau, Anke" sort="Liebetrau, Anke" uniqKey="Liebetrau A" first="Anke" last="Liebetrau">Anke Liebetrau</name><name sortKey="Mossner, Joachim" sort="Mossner, Joachim" uniqKey="Mossner J" first="Joachim" last="Mössner">Joachim Mössner</name><name sortKey="Schiefke, Ingolf" sort="Schiefke, Ingolf" uniqKey="Schiefke I" first="Ingolf" last="Schiefke">Ingolf Schiefke</name><name sortKey="Tiedemann, Astrid" sort="Tiedemann, Astrid" uniqKey="Tiedemann A" first="Astrid" last="Tiedemann">Astrid Tiedemann</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Teich, Niels" sort="Teich, Niels" uniqKey="Teich N" first="Niels" last="Teich">Niels Teich</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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