Serologic Status of Routine Childhood Vaccines, Cytomegalovirus, and Epstein-Barr Virus in Children With Inflammatory Bowel Disease

Inflamm Bowel Dis. 2019 Jun 18;25(7):1218-1226. doi: 10.1093/ibd/izy366.

Abstract

Background: Data on the serologic status of childhood vaccines, cytomegalovirus (CMV) and Epstein-Barr virus (EBV), are limited in inflammatory bowel disease (IBD). Therefore, we evaluated vaccine coverage and seroprotection, along with CMV and EBV seropositivity, in pediatric IBD.

Methods: In a cross-sectional study, demographic data, IBD history, vaccine records, and serum for antibodies against measles, mumps, rubella, diphtheria, tetanus, varicella, hepatitis B (HBV), CMV, and EBV were collected from children with IBD. We evaluated potential factors associated with serologic status.

Results: Of 156 subjects, vaccine coverage was up to date for age in 93.5% for measles, mumps, rubella, 95.6% for diphtheria, tetanus, pertussis, polio, hemophilus influenza B, 75.8% for HBV, and 93.5% for varicella, including past infection and vaccination. Seroprotection was present in 65.8% for measles, 60.5% for mumps, 79.1% for rubella, 79.5% for diphtheria, 80.8% for tetanus, 70.5% for varicella, and 62.8% for HBV of subjects. Older age at diagnosis was associated with seroprotection among subjects with complete HBV (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.03-1.39) and rubella series (OR, 1.18; 95% CI, 1.02-1.37). Older age at serum collection was associated with seroprotection among subjects with prior varicella vaccination or infection (OR, 1.69; 95% CI, 1.33-2.15). Only 25.2% and 37.8% demonstrated seropositivity to CMV and EBV, respectively. Among subjects on immunosuppressive medications, 75.3% and 62.4% were seronegative for CMV and EBV, respectively.

Conclusions: Children with IBD have low serologic protection to childhood vaccines in spite of high vaccine coverage and universal vaccinations. Children with IBD, including a large proportion on immunosuppressive medications, have low seropositivity to CMV and EBV.

Keywords: Epstein-Barr virus; cytomegalovirus; inflammatory bowel disease; serology; vaccine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Corynebacterium diphtheriae / immunology
  • Corynebacterium diphtheriae / isolation & purification
  • Cross-Sectional Studies
  • Cytomegalovirus / immunology
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / prevention & control
  • Cytomegalovirus Infections / virology
  • Diphtheria / blood
  • Diphtheria / immunology
  • Diphtheria / prevention & control
  • Diphtheria / virology
  • Epstein-Barr Virus Infections / blood
  • Epstein-Barr Virus Infections / immunology*
  • Epstein-Barr Virus Infections / prevention & control
  • Epstein-Barr Virus Infections / virology
  • Female
  • Follow-Up Studies
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / immunology*
  • Inflammatory Bowel Diseases / virology
  • Male
  • Prognosis
  • Serologic Tests
  • Tetanus / blood
  • Tetanus / immunology
  • Tetanus / prevention & control
  • Tetanus / virology
  • Vaccination
  • Viral Load / immunology*
  • Viral Vaccines / administration & dosage*

Substances

  • Immunosuppressive Agents
  • Viral Vaccines