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Strategies to Improve Influenza Vaccination in Pediatric Inflammatory Bowel Disease Through Education and Access
Kathleen Huth1, Eric I Benchimol, Mary Aglipay
1*Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada; †School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, Canada; ‡Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada; and §CHEO IBD Centre, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Insights
Influenza vaccination rates in pediatric inflammatory bowel disease patients increased significantly with an educational intervention and in-clinic vaccine provision. These strategies effectively addressed barriers to vaccination, improving uptake for this high-risk group.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Influenza vaccination rates are low in pediatric patients with inflammatory bowel disease (IBD).
- IBD patients face higher risks of severe influenza complications.
- Barriers to vaccination in this population require targeted interventions.
Purpose of the Study:
- To identify barriers to influenza vaccination in pediatric IBD patients.
- To evaluate the effectiveness of an educational intervention on vaccination rates.
- To assess the impact of providing influenza vaccine access during clinic visits.
Main Methods:
- A prospective cohort study conducted over two influenza seasons.
- Year 1: Survey of parents and adolescents (≥14 years) on vaccination barriers.
- Year 2: Implementation of an educational module and in-clinic vaccine provision, with subsequent analysis of vaccination rates.
Main Results:
- In Year 1, only 47% of pediatric IBD patients received the influenza vaccine, with perceived lack of benefit and adverse event concerns cited as primary barriers.
- In Year 2, vaccination rates increased to 75.0% with education alone and 89.5% with education plus in-clinic vaccine access (P=0.0043).
- Among patients participating in both years, vaccination rates rose from 45% to 82% (P<0.0001).
Conclusions:
- Educational interventions significantly improve influenza vaccination rates in pediatric IBD patients.
- Offering influenza vaccination directly during clinic visits further enhances vaccine uptake.
- These combined strategies are effective in overcoming barriers and increasing vaccination coverage in this vulnerable population.
Background:
Influenza vaccine uptake remains low in patients with inflammatory bowel disease despite an increased risk of complications from infection. We studied barriers to vaccination and evaluated the impact of an educational intervention and vaccine provision in pediatric patients with inflammatory bowel disease.
Methods:
A prospective cohort study was completed over 2 successive influenza seasons. In year 1, we surveyed parents and patients aged 14 years or older regarding influenza vaccination. In year 2, before the influenza season, patients were provided with an educational module. After influenza vaccine availability, patients were offered both education and vaccine in clinic. Chi-squared analysis was used to identify significant differences in vaccination rates in each intervention group. Demographic factors were associated with vaccination status.
Results:
In year 1, 180 parents and 183 adolescents completed the survey. In year 1, 47% of patients obtained the influenza vaccine and 34% of patients reported obtaining the vaccine annually. Top reasons for nonvaccination were perceived lack of benefit (28%) and concerns about adverse events (19%). In year 2 (n = 228), the vaccination rate in patients who received the education alone was 75.0%, compared with 89.5% of patients who received both education and vaccine access in clinic (P = 0.0043). Among the patients who took part in both study years (n = 129), influenza vaccination rates increased from 45% in year 1 to 82% in year 2 (P < 0.0001).
Conclusions:
The educational intervention was associated with improved influenza vaccination rates. Additional vaccine uptake was achieved with provision of influenza vaccination during clinic visits.
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