Vaccine-Preventable Herpes Zoster More Common in IBD Hospital Patients

Recent research presented at Digestive Disease Week 2018 showed that patients hospitalized with inflammatory bowel disease (IBD) were more likely to be admitted with herpes zoster infection compared with non-IBD patients.

“IBD entails a higher risk of life-threatening infections, including those that could be prevented with immunizations,” Daniela Guerrero Vinsard, MD, of the University of Connecticut Health Center, and colleagues wrote in their study. “Vaccination strategies for patients with IBD have been proposed by the Advisory Committee on Immunization Practices; however, gastroenterologists and primary care providers continue to face contradictions regarding risks and benefits of vaccinations in the setting of patients with immune dysregulation and undergoing therapies involving immunosuppression.”

In order to examine which vaccinations patients with IBD are most in need of pre- and during hospitalization, the researchers measured the proportion of IBD patients admitted to the hospital with vaccine preventable disease. The vaccine-preventable diseases they measured for included: pneumococcal pneumonia, herpes zoster, varicella zoster, meningococcal meningitis, influenza, tetanus, diphtheria, pertussis, hepatitis A, hepatitis B, and HPV. In all, the researchers studied 41,246 patients hospitalized with IBD admitted with a vaccine preventable disease.

The researchers found that 32.9% of IBD patients were admitted with hepatitis B, 30.4% were admitted with herpes zoster, and 18.9% were admitted with pneumococcal pneumonia. The rest of the vaccine preventable diseases measured for made up less than 10% of patients admitted with IBD.

Dr Vinsard and colleagues found that herpes zoster had an incidence rate among patients with IBD that was significantly higher that the incidence rate in 40,849 non-IBD patients (39.6% vs 30.27%). There were no significant differnces in incidence rates between IBD patients and non-IBD patients for the other vaccine preventable disease.

“IBD patients have a higher rate of hospital admissions with herpes zoster when compared to the non-IBD population,” the researchers concluded. “Recommendations regarding immunization strategies for this disease should be further revised. For other vaccine-preventable illness, IBD patients have the same rate of admission as the general population and should continue to follow their regular immunization schedule.”

—David Costill

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