Q&A: Do Enough Adults With IBD Receive the Herpes Zoster Vaccine?

Individuals with inflammatory bowel disease (IBD) are at increased risk for herpes zoster. Currently, adults aged 50 years and older are recommended to receive the recombinant zoster vaccination. It is even more crucial that individuals with IBD be vaccinated due to the risk of more frequent and severe complications.

Despite its importance, physician adherence to vaccination guidelines and the rate of herpes zoster vaccination is currently unknown.

A new study¹ led by Dr Marie Borum, director of the division of gastroenterology and liver disease and professor of medicine at George Washington University, found that individuals with IBD are not often recommended the varicella zoster vaccine, despite current guidelines.

In the study, Borum and colleagues evaluated 393 patients with IBD seen in the gastroenterology clinic of a university medical center over a 5-year period. The researchers measured patient age, gender, IBD diagnosis, overall vaccination documentation, and herpes zoster vaccination status.

Results showed that one-third of the cohort were older than 50 years of age, yet vaccination rates were considered modest. A total 4.3% of patients had a documented varicella-zoster vaccine with an average age of vaccination of 60.35 years.

Gastroenterology Consultant caught up with Borum to talk about her research that was recently presented during a poster session at the 2018 AIBD Meeting.

Gastroenterology Consultant: How did your study come about?

Marie Borum: An increasing number of individuals with inflammatory bowel disease presented to the university practice with severe herpes zoster. This observation prompted an assessment of the rate at which IBD patients were administered herpes zoster vaccination.

GASTRO CON: What do current guidelines state about individuals with IBD and the herpes zoster vaccine?

MB: The Centers for Disease Control recommends that adults aged 50 years and older be vaccinated with recombinant herpes zoster vaccine. There are no specific recommendations for individuals with IBD or for those who are immunosuppressed and under age 50.

GASTRO CON: Do you think enough specialists are recommending patients receive the herpes zoster vaccine? How can vaccine rates improve?

MB: This study suggests that physicians infrequently administer herpes zoster immunization in those who are eligible. However, this may be related to a variety of factors such as physician awareness, patient acceptance, vaccine availability, and insurance reimbursement.

GASTRO CON: What are the challenges associated with an individual with IBD receiving herpes zoster vaccination?

MB: Individuals aged 50 years and older with IBD should receive herpes zoster vaccination. The CDC has recommended that immunization can be administered in those who are taking low-dose immunosuppressive therapy, are anticipating immunosuppression or who are recovering from an immunocompromising illness. Notably, those who are immunosuppressed may not fully respond to immunization.

GASTRO CON: What is the next step in your research?

MB: Efforts to increase physician and patient awareness of herpes zoster and availability for vaccination are important. Subsequent research can include vaccination rates after an educational intervention.

For more AIBD Meeting content, visit the AIBD Newsroom.

Reference:

Tabbara N, Greenfest A, Szvarca D, et al. One shingle at a time: The importance of improving zoster vaccination rates in the IBD population. Poster #019. Presented at: Advances in Inflammatory Bowel Diseases; December 13-15, 2018; Orlando, FL. https://www.consultant360.com/meetings/aibd.