Influenza immunization rates in children with inflammatory bowel disease (IBD) are low, but immunization is actually safe, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES), the Children's Hospital of Eastern Ontario (CHEO), the Ottawa Hospital Research Institute (OHRI) and the University of Ottawa.
Yearly influenza immunization is recommended for patients with IBD, including Crohn's disease and ulcerative colitis. However, concern about vaccine-related adverse events may limit immunization uptake. Given that Ontario has the highest rates of childhood-onset IBD in the world and offers universal influenza immunizations to everyone more than six months old, the province offers an optimal setting to evaluate rare outcomes in children with IBD, such as adverse events following immunization.
While influenza immunization rates in children with IBD are low, immunization did not result in increased adverse events or contacts with the health system, says Dr. Eric Benchimol, lead author, adjunct scientist at ICES, principal investigator at the CHEO Research Institute and assistant professor at the Faculty of Medicine at University of Ottawa.
The study examined all children under 19 years of age diagnosed with IBD in Ontario between 1999 and 2009 and matched them to non-IBD controls. It found the following:
- 25.3% of IBD patients received immunization from a physician or nurse practitioner.
- There was no increased adverse event rates in IBD cases after children received the immunization, compared to control periods.
- IBD-related visit rates were lower after children received the immunization compared to control periods.
There is no risk of IBD flare-up following influenza immunization. In fact, in the years they were immunized, children with IBD had lower rates of IBD-related outpatient physician visits compared to years they were not immunized. This may indicate that receiving the influenza vaccine protects against having a flare-up of IBD, or at least prevents visits to doctors for IBD-related symptoms, says Benchimol.
The researchers add that the lack of increased health services use for IBD-related concerns in the post-vaccine risk period by IBD patients, and evidence of a protective effect of influenza immunization against IBD-related health services use, should encourage improvement in poor flu vaccination uptake rates.
The study, Safety and utilization of influenza immunization in children with inflammatory bowel disease,was published today in Pediatrics.
Authors: Eric I. Benchimol, Steven Hawken, Jeffrey C. Kwong, Kumanan Wilson.
More detailed study findings are available on the ICES website.
About the Institute for Clinical Evaluative Sciences (ICES)
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.
About the CHEO Research Institute
The CHEO Research Institute coordinates the research activities of the Children's Hospital of Eastern Ontario (CHEO) and is affiliated with the University of Ottawa. Its three programs of research include molecular biomedicine, health technology and evidence to practice research. Key research themes include cancer, diabetes, obesity, mental health, emergency medicine, musculoskeletal health, electronic health information and privacy, and genetics of rare disease. The CHEO Research Institute makes discoveries today for healthier kids tomorrow. For more information, visit www.cheori.org.
About the Ottawa Hospital Research Institute (OHRI)
The Ottawa Hospital Research Institute (OHRI) is the research arm of the Ottawa Hospital and is an affiliated institute of the University of Ottawa, closely associated with the University's faculties of Medicine and Health Sciences. OHRI includes more than 1,700 scientists, clinical investigators, graduate students, postdoctoral fellows and staff conducting research to improve the understanding, prevention, diagnosis and treatment of human disease. Research at OHRI is supported by the Ottawa Hospital Foundation. www.ohri.ca
About the University of Ottawa
The University of Ottawa is committed to research excellence and encourages an interdisciplinary approach to knowledge creation, which attracts the best academic talent from across Canada and around the world. It is an important stakeholder in the National Capital Region's economic development.
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