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Abstract
OBJECTIVE: Influenza immunization is recommended for children with IBD, however safety concerns may limit uptake. This study assessed whether immunization was associated with adverse events in IBD patients using a population-based database of children with IBD.
METHODS: All children <19 years diagnosed with IBD in Ontario, Canada between 1999–2009 were identified using health administrative data, and matched to non-IBD controls. Self-controlled case series (SCCS) analyses determined health services event rates (outpatient visits, hospitalizations and emergency visits) in any 2-week risk period to 180 days post-immunization compared to a no-risk control period. Relative incidence (RI) was calculated for overall and IBD-related events and rates were compared between IBD cases and controls using relative incidence ratios (RIR).
RESULTS: A total of 4916 IBD patients were matched to 21 686 controls. IBD patients were more likely to have received immunization than controls (25.3% vs 13.2%, P < .001). No increased event rates existed in IBD cases during risk periods (pooled RI 0.95, 95% CI 0.84–1.07), including hospitalizations and emergency visits. There was a slightly higher event rate in IBD cases versus controls for days 3–14 (RIR 1.60, 95% CI 1.05–2.44, P = .03). IBD-related visit rates were lower in risk periods compared to control period (pooled RI 0.81, 95% CI 0.68–0.96).
CONCLUSIONS: There was no increase in health services use in the post-vaccine risk period in IBD patients, and there was evidence for a protective effect of influenza immunization against IBD-related health services use. Influenza immunization is safe in children with IBD and should be encouraged to improve poor coverage rates.
- epidemiology
- health administrative data
- inflammatory bowel diseases
- influenza vaccines
- pediatrics
- seasonal influenza
- vaccine safety
- CD —
- Crohn’s disease
- CI —
- confidence intervals
- ED —
- emergency department
- IBD —
- inflammatory bowel disease
- OCCC —
- Ontario Crohn’s and Colitis Cohort
- OHIP —
- Ontario Health Insurance Plan
- SCCS —
- self-controlled case series
- RI —
- relative incidence
- RIR —
- relative incidence ratio
- UC —
- ulcerative colitis
- Accepted February 22, 2013.
- Copyright © 2013 by the American Academy of Pediatrics
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