Respiratory Syncytial Virus Vaccination Rates in Patients With Inflammatory Bowel Disease

Background:
Respiratory syncytial virus (RSV) is a viral infection that commonly affects infants, older adults, and immunocompromised patients. Patients with inflammatory bowel disease (IBD) are at an increased risk for infections inherent to their disease state or use of immunosuppressive medications. Introduction of the RSV vaccine in May 2023 provided another means to decrease the morbidity and mortality associated with RSV infection in high-risk patients 60 years and older as well as all adults 75 years and older. We aimed to describe the rates of RSV vaccination in patients with IBD compared to patients without IBD.
Methods:
This was a multicenter retrospective study of RSV vaccination rates in eligible adult patients with and without IBD between May 2023 and August 2024. Patients with IBD were identified with ICD-10 codes K51.x (ulcerative colitis) and K50.x (Crohn’s disease). Inclusion criteria were patients aged 60 and older with a documented clinic appointment with any provider within the past year and either Abrysvo or Arexvy administration. Patients with IBD were abstracted for prescription of infliximab or biosimilar, adalimumab or biosimilar, vedolizumab, ustekinumab, upadacitinib, tofacitinib, azathioprine, mercaptopurine, methotrexate, and cyclosporine.
Results:
There were 5,037 eligible patients with IBD and 282,101 eligible patients without IBD identified who met the inclusion criteria. Of the 5,037 eligible patients with IBD, 585 (12%) patients received either RSV vaccination between May 2023 and August 2024. Of these 585 patients, 336 (57%) were being treated for IBD with either an immunomodulator or advanced therapy. Of the remaining 4,452 patients with IBD who did not receive an RSV vaccination, 1,333 patients (30%) were being treated for IBD with either an immunomodulator or advanced therapy. Of the 282,101 eligible patients without IBD, 22,008 patients (8%) received either RSV vaccination in the specified time.
Conclusions:
RSV infections are associated with significant morbidity and mortality that could likely be mitigated by patient education on RSV vaccination in patients at high risk for complications including patients with IBD. We found similar rates of low RSV vaccinations between eligible patients with and without IBD. Additionally, patients with IBD on immune-modifying therapies were nearly twice as likely to have received an RSV vaccination than those not on such therapies. Gastroenterologists and primary care clinicians should actively educate and promote immunizations against RSV in their at-risk patients.