tetano
Editor, Senior Moderator
Safety and Utilization of Influenza Immunization in Children With Inflammatory Bowel Disease
Eric I. Benchimola,b,c,d,
Steven Hawkend,
Jeffrey C. Kwongd,e,f,g, and
Kumanan Wilsonc,d,h
+ Author Affiliations
aCHEO IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Children?s Hospital of Eastern Ontario, Ottawa, Ontario, Canada;
Departments of bPediatrics,
cEpidemiology and Community Medicine, and
hMedicine, University of Ottawa, Ottawa, Ontario, Canada;
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;
eDepartment of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; and
fPublic Health Ontario, Toronto, Ontario, Canada;
gUniversity Health Network, Toronto, Ontario, Canada
Abstract
OBJECTIVE: Influenza immunization is recommended for children with IBD, however safety concerns may limit uptake. This study assessed whether immunization was associated with adverse events in IBD patients using a population-based database of children with IBD.
METHODS: All children <19 years diagnosed with IBD in Ontario, Canada between 1999?2009 were identified using health administrative data, and matched to non-IBD controls. Self-controlled case series (SCCS) analyses determined health services event rates (outpatient visits, hospitalizations and emergency visits) in any 2-week risk period to 180 days post-immunization compared to a no-risk control period. Relative incidence (RI) was calculated for overall and IBD-related events and rates were compared between IBD cases and controls using relative incidence ratios (RIR).
PEDIATRICS
(doi: 10.1542/peds.2012-3567)
RESULTS: 4916 IBD patients were matched to 21,686 controls. IBD patients were more likely to have received immunization than controls (25.3% vs. 13.2%, P < .001). No increased event rates existed in IBD cases during risk periods (pooled RI 0.95, 95% CI 0.84?1.07), including hospitalizations and emergency visits. There was a slightly higher event rate in IBD cases versus controls for days 3?14 (RIR 1.60, 95% CI 1.05?2.44, P = .03). IBD-related visit rates were lower in risk periods compared to control period (pooled RI 0.81, 95% CI 0.68?0.96).
CONCLUSIONS: There was no increase in health services use in the post-vaccine risk period in IBD patients, and there was evidence for a protective effect of influenza immunization against IBD-related health services use. Influenza immunization is safe in children with IBD and should be encouraged to improve poor coverage rates.
http://pediatrics.aappublications.org/content/early/2013/04/30/peds.2012-3567.abstract
Eric I. Benchimola,b,c,d,
Steven Hawkend,
Jeffrey C. Kwongd,e,f,g, and
Kumanan Wilsonc,d,h
+ Author Affiliations
aCHEO IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Children?s Hospital of Eastern Ontario, Ottawa, Ontario, Canada;
Departments of bPediatrics,
cEpidemiology and Community Medicine, and
hMedicine, University of Ottawa, Ottawa, Ontario, Canada;
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;
eDepartment of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; and
fPublic Health Ontario, Toronto, Ontario, Canada;
gUniversity Health Network, Toronto, Ontario, Canada
Abstract
OBJECTIVE: Influenza immunization is recommended for children with IBD, however safety concerns may limit uptake. This study assessed whether immunization was associated with adverse events in IBD patients using a population-based database of children with IBD.
METHODS: All children <19 years diagnosed with IBD in Ontario, Canada between 1999?2009 were identified using health administrative data, and matched to non-IBD controls. Self-controlled case series (SCCS) analyses determined health services event rates (outpatient visits, hospitalizations and emergency visits) in any 2-week risk period to 180 days post-immunization compared to a no-risk control period. Relative incidence (RI) was calculated for overall and IBD-related events and rates were compared between IBD cases and controls using relative incidence ratios (RIR).
PEDIATRICS
(doi: 10.1542/peds.2012-3567)
RESULTS: 4916 IBD patients were matched to 21,686 controls. IBD patients were more likely to have received immunization than controls (25.3% vs. 13.2%, P < .001). No increased event rates existed in IBD cases during risk periods (pooled RI 0.95, 95% CI 0.84?1.07), including hospitalizations and emergency visits. There was a slightly higher event rate in IBD cases versus controls for days 3?14 (RIR 1.60, 95% CI 1.05?2.44, P = .03). IBD-related visit rates were lower in risk periods compared to control period (pooled RI 0.81, 95% CI 0.68?0.96).
CONCLUSIONS: There was no increase in health services use in the post-vaccine risk period in IBD patients, and there was evidence for a protective effect of influenza immunization against IBD-related health services use. Influenza immunization is safe in children with IBD and should be encouraged to improve poor coverage rates.
http://pediatrics.aappublications.org/content/early/2013/04/30/peds.2012-3567.abstract