Uptake, safety and effectiveness of inactivated influenza vaccine in inflammatory bowel disease: a UK-wide study

Nakafero, Georgina; Grainge, Matthew J.; Card, Tim; Mallen, Christian D.; Nguyen Van-Tam, Jonathan S.; Abhishek, Abhishek

Abstract

Objective To investigate (1) the UK-wide inactivated influenza vaccine (IIV) uptake in adults with inflammatory bowel disease (IBD), (2) the association between vaccination against influenza and IBD flare and (3) the effectiveness of IIV in preventing morbidity and mortality.

Design Data for adults with IBD diagnosed before the 1 September 2018 were extracted from the Clinical Practice Research Datalink Gold. We calculated the proportion of people vaccinated against seasonal influenza in the 2018–2019 influenza cycle. To investigate vaccine effectiveness, we calculated the propensity score (PS) for vaccination and conducted Cox proportional hazard regression with inverse-probability treatment weighting on PS. We employed self-controlled case series analysis to investigate the association between vaccination and IBD flare.

Results Data for 13 631 people with IBD (50.4% male, mean age 52.9 years) were included. Fifty percent were vaccinated during the influenza cycle, while 32.1% were vaccinated on time, that is, before the seasonal influenza virus circulated in the community. IIV was associated with reduced all-cause mortality (aHR (95% CI): 0.73 (0.55,0.97) but not hospitalisation for pneumonia (aHR (95% CI) 0.52 (0.20–1.37), including in the influenza active period (aHR (95% CI) 0.48 (0.18–1.27)). Administration of the IIV was not associated with IBD flare.

Conclusion The uptake of influenza vaccine was low in people with IBD, and the majority were not vaccinated before influenza virus circulated in the community. Vaccination with the IIV was not associated with IBD flare. These findings add to the evidence to promote vaccination against influenza in people with IBD.

Citation

Nakafero, G., Grainge, M. J., Card, T., Mallen, C. D., Nguyen Van-Tam, J. S., & Abhishek, A. (2024). Uptake, safety and effectiveness of inactivated influenza vaccine in inflammatory bowel disease: a UK-wide study. BMJ Open Gastroenterology, 11(1), Article e001370. https://doi.org/10.1136/bmjgast-2024-001370

• Journal Article Type: Article
• Acceptance Date: May 26, 2024
• Online Publication Date: Jun 18, 2024
• Publication Date: Jun 18, 2024
• Deposit Date: Jun 22, 2024
• Publicly Available Date: Jun 24, 2024
• Journal: BMJ Open Gastroenterology
• Electronic ISSN: 2054-4774
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 1
• Article Number: e001370
• DOI: https://doi.org/10.1136/bmjgast-2024-001370
• Public URL: https://nottingham-repository.worktribe.com/output/36307292
• Publisher URL: https://bmjopengastro.bmj.com/content/11/1/e001370