Effects of implementing a vaccination tool in the electronic medical record on vaccination coverage of patients with immune-mediated inflammatory diseases: a prospective cohort study

Infect Dis (Lond). 2024 Oct;56(10):870-879. doi: 10.1080/23744235.2024.2361795. Epub 2024 Jun 7.

Abstract

Background: The rising incidence of immune-mediated inflammatory diseases (IMID) requires innovative management strategies, including effective vaccination. We aimed to assess the impact of an electronic medical record (EMR)-integrated vaccination tool on vaccination coverage among patients with inflammatory bowel diseases (IBD), rheumatological and dermatological conditions.

Methods: A prospective observational study compared vaccination coverage before (2018) and after (2021) implementing the module. Vaccination data for influenza, pneumococcus, hepatitis B and tetanus, and potential predictors were collected from 1430 IMID patients (44.9% male, median age (interquartile range [IQR]) 54 (40-66) years, 789 with IBD, 604 with rheumatological and 37 with dermatological conditions). Data were analysed using McNemar, chi-square tests and multinominal logistic regression.

Results: Significant increases in pneumococcus (56.6% to 73.1%, p < .001) and hepatitis B vaccination (62.2% to 75.9%, p < .001) were observed. Influenza vaccination rates increased among IBD (76.2% to 80.5%, p = .006) but remained stable overall (73.1% to 73.2%, p = 1.000). Tetanus vaccination rates decreased (71.5% to 55.0%, p < .001). The proportion of fully vaccinated patients (against influenza in the past year for patients >50 years old and/or under immunosuppressive therapy, against pneumococcus in the past 5 years for patients >65 years old and/or under immunosuppressive therapy and additionally against hepatitis B for IBD patients) rose from 41.3% to 54.8% (p < .001 all using McNemar). Factors associated with vaccinations included age, immunosuppressive therapy and education level.

Conclusions: Increased vaccination coverage was measured after implementing the vaccination tool. The COVID19 pandemic and the 2018 measurement might have increased vaccination awareness. Education of patients and healthcare professionals remains crucial.

Keywords: Inflammatory bowel disease; dermatology; infectious diseases; rheumatology; vaccination.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Electronic Health Records*
  • Female
  • Hepatitis B Vaccines / administration & dosage
  • Hepatitis B Vaccines / immunology
  • Humans
  • Inflammatory Bowel Diseases / drug therapy
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / immunology
  • Male
  • Middle Aged
  • Pneumococcal Vaccines / administration & dosage
  • Pneumococcal Vaccines / immunology
  • Prospective Studies
  • Vaccination / statistics & numerical data
  • Vaccination Coverage* / statistics & numerical data

Substances

  • Influenza Vaccines
  • Pneumococcal Vaccines
  • Hepatitis B Vaccines