Related Experiment Video
Updated: Nov 10, 2025
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Vaccination Rates and Family Barriers Among Children with Inflammatory Bowel Disease
Kathleen J Holland1, Tracey A Wilkinson2, Erin Phipps3
1Pediatric Gastroenterology, Hepatology and Nutrition Fellow, Indiana University School of Medicine, 705 Riley Hospital Drive ROC 4210, Indianapolis, IN 46202, 317-944-3774.
Insights
Caregivers of children with inflammatory bowel disease (IBD) show increased vaccine safety concerns, leading to missed immunizations. This highlights a critical gap in recommended pediatric vaccinations for immunosuppressed IBD patients.
Area of Science:
- Pediatric immunology
- Gastroenterology
- Public health
Background:
- Children with inflammatory bowel disease (IBD) often require immunosuppressants, increasing vulnerability to vaccine-preventable diseases.
- National guidelines recommend vaccinations, yet vaccination rates remain low in pediatric IBD populations.
- Existing adult data suggest vaccine safety concerns, but research on pediatric IBD families' perceptions is lacking.
Purpose of the Study:
- To investigate vaccine safety and effectiveness perceptions among caregivers of children with IBD.
- To compare these perceptions with caregivers of children without IBD.
- To assess vaccination status in pediatric IBD patients.
Main Methods:
- Surveyed 108 caregivers of children (ages 10-25) with and without IBD using validated vaccine safety and opinion questions.
- Collected state-wide vaccine registry data post-enrollment.
- Compared demographics and analyzed Likert scale responses using Ch-square and Wilcoxon rank-sum tests.
Main Results:
- IBD caregivers reported higher concerns regarding vaccine safety (40% vs. 16%) and effectiveness (34% vs. 12%).
- A significant proportion of IBD families (36%) feared vaccines worsening their child's condition.
- Many children, particularly those on biologics for IBD, were missing key vaccines like influenza, HPV, and the PPSV23 booster.
Conclusions:
- Caregivers of children with IBD exhibit greater apprehension about vaccine safety and effectiveness compared to non-IBD groups.
- Despite immunosuppression and increased risk, pediatric IBD patients have suboptimal vaccination rates, indicating a need for targeted interventions.
Background:
Many children with inflammatory bowel disease (IBD) are taking immunosuppressant medications that place them at risk for vaccine preventable diseases. Despite national guidelines, children with IBD have low vaccination rates. Adult data suggest that there is concern about the safety of vaccines. There are no current studies addressing perceived safety about vaccinations among families of children with IBD.
Methods:
A total of 108 caregivers of children (ages 10-25 years) were surveyed during their outpatient visit, with approximately half having a diagnosis of IBD. The survey consisted of validated questions regarding vaccine safety and opinions. After enrollment, state-wide vaccine registry data was collected. Demographics between the two groups were compared using Ch-square and the Wilcoxon rank-sum tests to analyze Likert scale questions.
Results:
The majority of children followed for IBD were Caucasian males, had Crohn's disease (68%) and were immunosuppressed. Results from the survey revealed a concern about vaccine safety (40% vs. 16%, p=0.03) and overall effectiveness (34% vs. 12%, p<0.01) in the IBD group compared to the non-IBD. Furthermore, more IBD families were worried that vaccines would worsen their child's symptoms (36% vs. 10%, p=<0.01). The majority of children were missing the flu and/or HPV vaccine. Finally, 96% of the children on a biologic for their IBD were missing the PPSV23 booster.
Conclusions:
Caregivers of children with IBD are more concerned about vaccine safety and effectiveness than those with non-IBD diagnosis. Despite being on immunosuppressant medications, many patients were missing recommended vaccines.
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents