Adherence to Vaccination Program in Inflammatory Bowel Disease
Bibliographic record
Abstract
Due to the increase of infections in patients with inflammatory bowel disease (IBD), recently the administration of vaccines has been recommended from various medical societies. Multiple vaccines have been indicated in these patients. The implementation of vaccination programs involves many medical visits. There are no studies evaluating the adherence to vaccination programs in IBD. In our center we have a vaccination program for patients on anti-TNFα therapy. We conducted an observational retrospective study with prospective follow up to evaluate the adherence to vaccination program of these patients. The patients were vaccinated against influenza, tetanus, diphtheria, hepatitis A, hepatitis B, Streptococcus pneumoniae, Neisseria meningitidis serogroup C and Haemophilus influenzae type B. The adherence was assessed by two parameters: the “inclusion” and the “fulfillment” of the vaccination program. In addition we evaluated multiple clinical and demographic variables as predictive factors of non-adherence: sex, age, type of IBD, Montreal classification for IBD, time evolution of IBD, perianal disease, clinical activity of IBD, previous bowel resection, extraintestinal manifestations, comorbidity, concomitant treatment, gastroenterologist, preventive medicine physician, civil status, offspring, employment status and studies. In the period of the study 115 IBD patients were valid for vaccine program. Only 84 (73%) patients attended the first visit of Preventive Medicine Service. Non-inclusion causes reported by patients were: 16 (52%) patients related that were not referred to Preventive Medicine Service, 5 (16%) inconvenience, 5 (16%) lack of belief in the effect of vaccines, 2 (7%) oversight and 3 (9%) other causes. By univariate analysis the only predictive factor associated with non-inclusion was the medical follow-up by gastroenterologist non-specialist in IBD care (40.9%/18.3% p = 0.008). Of the total 84 patients included in vaccination program only 65 (77.4%) patients completed de vaccination program. Non-fulfillment causes reported by patients were: 6 (32%) patients related inconvenience, 4 (21%) lack of belief in the effect of vaccines, 4 (21%) oversight, 3 (16%) IBD activity and 2 (10%) other causes. The univariate analysis did not show predictive factors associated with non-fulfillment. The global adherence to vaccination program was 56.5%. The establishing of vaccination program in our hospital for patients with IBD on anti-TNFα therapy has had a suboptimal adherence. The gastroenterologist attitude was essential for the inclusion but not for the fulfillment of the program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".