BACKGROUND: Vaccine-preventable diseases and opportunistic infections in pediatric inflammatory bowel disease (IBD) are increasingly recognized issues. The aims of this study were to evaluate vaccinations, immunization status, and consequent therapeutic management in children with IBD and to analyze the differences among patients diagnosed before (Group 1) and after June 2012 (Group 2). METHODS: This was a multicenter, retrospective cohort investigation. Between July 2016 and July 2017, 430 children with IBD were enrolled in 13 centers. Diagnosis, therapeutic history, vaccinations, and immunization status screening at diagnosis and at immunosuppressant (IM)/biologic initiation and reasons for incomplete immunization were retrieved. RESULTS: Vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (89.3%), Haemophilus influenzae (81.9%), meningococcus C (23.5%), chickenpox (18.4%), pneumococcus (18.6%), papillomavirus (5.9%), and rotavirus (1.9%). Complete immunization was recorded in 38/430 (8.8%) children, but specific vaccines were recommended in 79/430 patients (18.6%), without differences between the 2 groups. At IM start, 22% of children were tested for Epstein-Barr virus (EBV) status, with 96.2% of EBV-naïve patients starting azathioprine, without differences between Groups 1 and 2. Screening for latent tuberculosis (TB) before start of biologics was performed in 175/190 (92.1%), with up to 9 different screening strategies and numerous inconsistencies. CONCLUSIONS: We demonstrated a poor immunization status at diagnosis in children with IBD, which was not followed by proper vaccination catch-up. EBV status before IM initiation and latent TB before biologics were not adequately assessed. Thus, the overall impact of the current guidelines seems unsatisfactory.

2nd Department of Pediatrics 'Iuliu Hatieganu' University of Medicine and Pharmacy Emergency Clinical Hospital for Children Cluj Napoca Romania

Department of Pediatric Gastroenterology and Nutrition Medical University of Warsaw Warsaw Poland

Department of Pediatrics Gastroenterology and Nutrition Jagiellonian University Medical College Kracow Poland

Department of Pediatrics Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

Department of Pediatrics Sapienza University Rome Italy

Department of Translational Medical Science Section of Pediatrics University of Naples Federico 2 Napoli Italy; Napoli Italy

Department of Woman Child and General and Specialistic Surgery University of Campania Luigi Vanvitelli Napoli Italy

Institute of Gastroenterology Nutrition and Liver Diseases Schneider Children's Medical Center of Israel Petach Tikva affiliated with the Sackler faculty of Medicine Tel Aviv University Israel

Pediatric Department of 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Pediatric Gastroenterology and Cystic Fibrosis Unit University of Messina Messina Italy

Pediatric Gastroenterology and Nutrition Unit Hospital Materno Infantil Málaga Spain

Pediatric Institute AOK University of Debrecen Debrecen Hungary

Referral Center for Pediatric Gastroenterology and Nutrition Children's Hospital Zagreb University of Zagreb School of Medicine Zagreb University J J Strossmayer Osijek Croatia

Vilnius University Clinic of Children's Diseases Vilnius Lithuania

Inflamm Bowel Dis. 2020 Feb 11;26(3):e20. doi: 10.1093/ibd/izz326. PubMed

Inflamm Bowel Dis. 2020 Feb 11;26(3):e21. doi: 10.1093/ibd/izz327. PubMed

Inflamm Bowel Dis. 2020 Mar 4;26(4):e24. doi: 10.1093/ibd/izaa006. PubMed

Inflamm Bowel Dis. 2020 Mar 4;26(4):e28. doi: 10.1093/ibd/izaa005. PubMed

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