IMPLEMENTATION OF A VACCINATION TOOL IN THE ELECTRONIC PATIENT HEALTH RECORD COINCIDES WITH A SIGNIFICANT INCREASE IN VACCINATION COVERAGE.

BackgroundPatients with immune-mediated inflammatory diseases (IMID) are at higher risk for infectious diseases. Despite this increased risk and the available guidelines1,2, we reported a suboptimal vaccination rate of 27 % of IMID patients in 2018. In the meantime, a vaccination module was introduced in the electronic patient medical record (EMR) of our hospital to accurately document and monitor vaccination status of patients.ObjectivesTo evaluate the impact of a new vaccination module in the patient health record on vaccination coverage in a previously included IMID cohort.MethodsBetween Aug and Oct 2021, the vaccination status of 1435 (out of the original 1488) IMID patients (45 % male, median age 53.6 years) was collected (790 patients with IBD (inflammatory bowel diseases), 607 with rheumatologic inflammatory conditions (RHEU)(RA or SpA), and 38 with dermatologic inflammatory conditions(DER)) and was compared to that of 2018. The vaccination status for influenza (FLU), pneumococci (Pnc), hepatitis B (Hep B) and tetanus (TT) was obtained mainly through the patients’ electronic medical records. Missing data were added after contacting patients or their general practitioner.ResultsFrom 2018 to 2021, the overall vaccination coverage (excluding TT) of all IMID patients significantly increased from 42 % to 66 % (p<0.001, Figure 1).Figure 1.Percentages of total vaccination coverage in 2018 vs. 2021 in patients with IMID – TT vaccination excludedFor patients with RHEU, the vaccination coverage significantly increased, namely from 69.0% to 75 % for FLU (p<0.001), from 36 % to 89 % for Pnc (p<0.001), from 57 % to 73 % for Hep B (p<0.001) and from 34 % to 74 % overall (p=0.008) (Figure 1 and Table 1).Table 1.Vaccine coverage in 2018 vs. 2021 in patients with IMIDFLU (%)Pnc (%)Hep B*(%)TT (%)IBD (n=790)2018: 762018: 732018: 672018: 802021: 872021: 822021: 792021: 67p-value < 0.001p-value < 0.001p-value < 0.001p-value < 0.001RHEU (n=607)2018: 692018: 362018: 572018: 652021: 752021: 892021: 732021: 41%p-value < 0.001p-value < 0.001p-value < 0.001p-value = 0.038DER (n=38)2018: 742018: 612018: 472018: 792021: 712021: 822021: 652021: 71p-value = 0.116p-value = 0.401p-value < 0.001p-value = 0.394All IMID (n=1435)2018: 732018: 582018: 632018: 742021: 812021: 852021: 772021: 56p-value < 0.001p-value < 0.001p-value < 0.001p-value < 0.001*recommended in all seronegative IMID patients with IBD and patients at risk for other IMIDsSimilarly, the vaccination coverage in IBD patients increased significantly from 76 % to 87 % for FLU (p<0.001), from 73 % to 82 % for Pnc (p<0.001), from 67 % to 79 % for Hep B (p<0.001) and from 47 % to 61 % overall (p<0.001) (Figure 1 and Table 1).For patients with DER, vaccination coverage significantly increased from 47 % to 65 % for Hep B (p<0.001) (Table 1). TT vaccination coverage decreased in all 3 IMID groups from 2018 to 2021.ConclusionThe implementation of a vaccination tool integrated in the EMR coincided with a significant increase in vaccination rates and also in the total amount of IMID patients that were fully vaccinated according to guidelines. Quite likely, the suboptimal vaccination rate measured in 2018 and the COVID-19 pandemic also raised awareness among patients and healthcare professionals about the importance of following vaccination guidelines.References[1]Furer V, Rondaan C, Heijstek MW, et al. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2020 Jan;79(1):39-52. doi: 10.1136/annrheumdis-2019-215882. Epub 2019 Aug 14. PMID: 31413005.[2]Rahier JF, Magro F, Abreu C, et al. Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis. 2014;8:443–468.Disclosure of InterestsJohan Joly: None declared, Barbara Neerinckx Grant/research support from: pfizer, Kurt de Vlam Speakers bureau: Celgene Eli Lilly, Galapagos, Novartis, UCB, Consultant of: Celgene, Eli Lilly, Amgen, AbbVie, Galapagos, Novartis, UCB, Grant/research support from: Celgene and Galapagos, Liselotte Fierens: None declared, Els De Dycker: None declared, Tine Vanhoutvin: None declared, Petra De Haes Speakers bureau: Celgene, GSK, Novartis, Consultant of: Celgene, GSK, Novartis, Paul De Munter Grant/research support from: Sanofi-Pasteur, Joao Sabino Speakers bureau: Abbvie, Falk, Takeda, Janssen, Fresenius, Consultant of: Janssen, Ferring, Grant/research support from: Galapagos, Severine Vermeire Speakers bureau: AbbVie, Abivax, Agomab, Arena Pharmaceuticals, Avaxia, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Dr Falk Pharma, Ferring, Galapagos, Genentech-Roche, Gilead, GSK, Hospira, Janssen, Mundipharma, MSD, Pfizer, Prodigest, Progenity, Prometheus, Robarts Clinical Trials, Second Genome, Shire, Surrozen, Takeda, Theravance, Tillots Pharma AG, Consultant of: AbbVie, Abivax, Agomab, Arena Pharmaceuticals, Avaxia, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Dr Falk Pharma, Ferring, Galapagos, Genentech-Roche, Gilead, GSK, Hospira, Janssen, Mundipharma, MSD, Pfizer, Prodigest, Progenity, Prometheus, Robarts Clinical Trials, Second Genome, Shire, Surrozen, Takeda, Theravance, Tillots Pharma AG, Grant/research support from: AbbVie, J&J, Pfizer, Galapagos, Takeda, Marc Ferrante Speakers bureau: AbbVie, Amgen, Biogen, Boehringer Ingelheim, Falk, Ferring, Janssen, Lamepro, MSD, Mylan, Pfizer, Sandoz, Takeda, Truvion Healthcare, Consultant of: AbbVie, Boehringer Ingelheim, Celltrion, Janssen, Lilly, Medtronic, MSD, Pfizer, Sandoz, Takeda, Thermo Fisher, Grant/research support from: AbbVie, Amgen, Biogen, Janssen, Pfizer, Takeda, Viatris, Patrick Verschueren Speakers bureau: Eli Lilly, MSD, Galapagos, Roularta, Consultant of: Eli Lilly, Nordic Pharma, Galapagos, Gilead, Pfizer, ABBVIE, Celltrion, BMS, UCB, Pfizer, Sidekick Health, Grant/research support from: Pfizer