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Open Access Research article

An australian audit of vaccination status in children and adolescents with inflammatory bowel disease

Nigel W Crawford123*, Anthony G Catto-Smith234, Mark R Oliver234, Donald JS Cameron2457 and Jim P Buttery1267

Author Affiliations

1 SAEFVIC, Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Victoria 3011 Australia

2 Murdoch Childrens Research Institute (MCRI), Melbourne, Victoria 3011 Australia

3 Department of Paediatrics, The University of Melbourne, Victoria 3011 Australia

4 Department of Gastroenterology & Clinical Nutrition, RCH, Melbourne, Victoria 3011 Australia

5 Gastroenterology Unit, Monash Children's Hospital, Southern Health, Melbourne, Victoria 3011 Australia

6 Paediatric Infectious Diseases Unit, Monash Children's Hospital, Southern Health, Melbourne, Victoria 3011 Australia

7 Department of Paediatrics, Monash University, Melbourne, Victoria 3011 Australia

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BMC Gastroenterology 2011, 11:87  doi:10.1186/1471-230X-11-87

Published: 29 July 2011



Children and adolescents with inflammatory bowel disease (IBD) are at increased risk of vaccine preventable diseases (VPD). This includes invasive pneumococcal disease and influenza. The primary aim of this study was to describe compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD. A secondary aim was to review the serological screening for VPD.


A random sample of patients (0-18 years at diagnosis), were selected from the Victoria Australia state based Pediatric Inflammatory Bowel Disease Register. A multi-faceted retrospective review of immunization status was undertaken, with hospital records audited, a telephone interview survey conducted with consenting parents and the vaccination history was checked against the primary care physician and Australian Childhood Immunization Register (ACIR) records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified.


This 2007 audit reviewed the immunization status of 101individuals on the Victorian Pediatric IBD database. Median age at diagnosis was 12.1 years, 50% were on active immunosuppressive therapy. 90% (38/42) [95% confidence intervals (CI) 77%; 97%] with complete immunization information were up-to-date with routine primary immunizations. Only 5% (5/101) [95% CI 2%; 11%] received a recommended pneumococcal vaccine booster and 10% (10/101) [95% CI 5%; 17%] had evidence of having ever received a seasonal influenza vaccine. Those living in rural Victoria (p = 0.005) and younger at the age of diagnosis (p = 0.002) were more likely to have ever received an influenza vaccine Serological testing, reviewing historical protection from VPD, identified 18% (17/94) with evidence of at least one serology sample.


This study highlights poor compliance in IBD patients for additional recommended vaccines. A multi-faceted approach is required to maximize protection from VPD in this vulnerable special risk population.

pediatric; infections; inflammatory bowel disease; immunosuppressed; immunization