The Impact of Implementing Clinic-Administered Vaccines in an Inflammatory Bowel Disease Outpatient Clinic

Background:
Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic inflammatory condition that frequently requires long-term management with immunosuppressive therapies. These therapies, while effective for controlling disease activity, can compromise the immune system and increase susceptibility to infections. Vaccination is a crucial preventive measure to protect IBD patients from vaccine-preventable diseases. Adherence to vaccination schedules in this population may be suboptimal due to factors such as disease severity, concern of side effects, lack of information, or access. In 2024, the IBD program at Ochsner Health implemented clinic-administered immunizations to help improve patient access. This study aims to quantify the number of clinic-administered immunizations and evaluate the impact on vaccination rates.
Methods:
A retrospective analysis was conducted looking at the number of patients receiving vaccinations from January to August 2023, before implementation, and from January to August 2024, after implementation of clinic-administered vaccinations. Vaccinations are counted only after the patient has had an office visit with the gastroenterologist within the study period. For the year 2024 we looked at vaccines administered in clinic as well as outside of clinic.
Results:
In 2023 and 2024, 1,258 and 1,322 patients were seen in the IBD clinic between January and August, respectively. After at least 1 office visit with the gastroenterologist in 2024, 163 patients (12%) received their pneumococcal vaccine, and 119 of these vaccines were administered in clinic the same day or soon after the office visit. 139 patients (11%) received at least 1 shingles vaccine and 91 of them were administered in the clinic. 113 (9%) and 68 (5%) IBD patients received at least 1 dose of hepatitis A and 1 dose of hepatitis B, respectively. Seventy-four hepatitis A vaccines and 45 hepatitis B vaccines were administered in clinic. During the 2023 study period, 148 patients (12%) received their pneumococcal vaccine, 126 (10%) received at least 1 shingles vaccine, 87 (7%) received at least 1 hepatitis A vaccine, and 58 (5%) received at least 1 hepatitis B vaccine. All the vaccines in 2023 were administered in an outside clinic or pharmacy.
Conclusions:
In conclusion, the data from the IBD clinic for January through August of 2024 demonstrate vaccination rates that are largely comparable to those from the same period in 2023. The percentage of patients receiving pneumococcal (12% in 2024 vs 12% in 2023) and shingles vaccines (11% in 2024 vs 10% in 2023) remained stable. Hepatitis A and B vaccination rates showed slight increases in 2024 compared to 2023. A key difference observed is the significant rise in the number of vaccines administered directly within the clinic setting in 2024. This shift from external clinics and pharmacies to in-clinic vaccination not only highlights an improvement in vaccine accessibility but also reflects the clinic’s enhanced capacity to provide comprehensive care. Overall, the data emphasizes the effectiveness of integrating vaccination services into the clinic’s routine practice, which may help in further improving patient immunization rates. This could minimize admissions and unnecessary ED visits for vaccine-preventable diseases.