PDF(Pubmed)
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.
METHODS: 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.
CONCLUSIONS: 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.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
目的：研究（1）全英国范围的灭活疫苗（IIV）在成人炎症性肠病（IBD）中的摄取，（2）流感疫苗接种与IBD爆发之间的关系；（3）IIV预防发病率和死亡率的有效性。
方法：2018年9月1日前诊断为IBD的成人数据来自临床实践研究数据链金。我们计算了2018-2019年流感周期中接种季节性流感疫苗的比例。为了调查疫苗的有效性，我们计算了疫苗接种的倾向评分(PS),并对PS进行了Cox比例风险回归和逆概率治疗加权.我们采用自我对照病例系列分析来调查疫苗接种与IBD耀斑之间的关系。
结果：13631名IBD患者的数据（50.4%男性，平均年龄52.9岁)。50%的人在流感周期接种疫苗，而32.1%的人按时接种疫苗，也就是说,在季节性流感病毒在社区传播之前。IIV与全因死亡率降低相关(aHR(95%CI):0.73(0.55,0.97),但与肺炎住院无关(aHR(95%CI)0.52(0.20-1.37),包括在流感活动期（aHR（95％CI）0.48（0.18-1.27））。IIV的施用与IBD耀斑无关。
结论：IBD患者的流感疫苗摄入量较低，大多数人在流感病毒在社区传播之前没有接种疫苗。IIV疫苗接种与IBD发作无关。这些发现增加了促进IBD患者接种流感疫苗的证据。
方法：2018年9月1日前诊断为IBD的成人数据来自临床实践研究数据链金。我们计算了2018-2019年流感周期中接种季节性流感疫苗的比例。为了调查疫苗的有效性，我们计算了疫苗接种的倾向评分(PS),并对PS进行了Cox比例风险回归和逆概率治疗加权.我们采用自我对照病例系列分析来调查疫苗接种与IBD耀斑之间的关系。
结果：13631名IBD患者的数据（50.4%男性，平均年龄52.9岁)。50%的人在流感周期接种疫苗，而32.1%的人按时接种疫苗，也就是说,在季节性流感病毒在社区传播之前。IIV与全因死亡率降低相关(aHR(95%CI):0.73(0.55,0.97),但与肺炎住院无关(aHR(95%CI)0.52(0.20-1.37),包括在流感活动期（aHR（95％CI）0.48（0.18-1.27））。IIV的施用与IBD耀斑无关。
结论：IBD患者的流感疫苗摄入量较低，大多数人在流感病毒在社区传播之前没有接种疫苗。IIV疫苗接种与IBD发作无关。这些发现增加了促进IBD患者接种流感疫苗的证据。
