P0772 - Does Telemedicine Impact Influenza Vaccine Uptake in Patients With Inflammatory Bowel Disease?

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Mazen Almasry, MBBS

University of Wisconsin-Madison School of Medicine and Public Health
Madison, WI

Mazen Almasry, MBBS¹, Trevor Schell, MD¹, Luke Richard, MD¹, Francis A. Farraye, MD, MSc, MACG², Mary Hayney, PharmD, MPH³, Freddy Caldera, DO, MS⁴
¹University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; ²Mayo Clinic, Jacksonville, FL; ³University of Wisconsin-Madison School of Pharmacy, Madison, WI; ⁴University of Wisconsin School of Medicine and Public Health, Madison, WI

Introduction: Patients with IBD are at increased risk of vaccine-preventable diseases, including influenza. Annual influenza vaccine is recommended for all adults including patients with IBD. Despite these recommendations, vaccination rates remain low. The COVID-19 pandemic resulted in increased telemedicine (Tele-M) use to provide care. This shift raised a concern whether Tele-M may negatively impact the vaccination rates due to fewer in-person opportunities for vaccination. This study aims to evaluate the impact of Tele-M on influenza vaccine uptake and assess the predictors of vaccine uptake.

Methods: We performed a single-center, retrospective study evaluating the impact of Tele-M on influenza vaccine uptake among adult patients with IBD seen in clinic between 09/2021–04/2022. Patients with tele-visits only were designated to the Tele-M group, while patients with at least one in-person visit were designated to the control group. Vaccination status was confirmed using the Wisconsin Immunization Registry. The primary outcome was to evaluate the influenza vaccination frequency with respect to visit type. Secondary outcomes included evaluating the effect of Tele-M on other vaccinations including pneumococcal, hepatitis B, and zoster. Secondary outcomes also included evaluating predictors of influenza vaccine uptake.

Results: Five hundred forty-seven patients were enrolled in the study. Of those, 53.2% (n= 291) were in the Tele-M group as compared to 46.8% (n=256) in the control group. Influenza vaccine uptake was comparable between groups (69.0% vs 75.1%, respectively, p=0.11). Similarly, the uptake of other vaccines (pneumococcal, hepatitis B and zoster) was not impacted by Tele-M; p > 0.05 for all. Female gender, receiving the flu vaccine in 2020-2021, receiving ≥3 COVID-19 vaccines, and having higher Charlson comorbidity index were associated with higher influenza vaccine uptake rates, which was confirmed by univariate and multivariate logistic regression analysis. Age, immunosuppression, ethnicity, area deprivation index, type of IBD, and offering of vaccine by medical assistants prior to the visit were not predictors of vaccine uptake.

Discussion: Tele-M did not impact influenza vaccine uptake among patients with IBD. Similar results were seen with other vaccines. These findings provide some reassurance that tele-M visits will not impact vaccines uptake. Lack of comorbidities, male gender, and lack of prior vaccinations were associated with lower rates of vaccination.

Figure: Results

Predictors of Influenza Vaccine Uptake in Patients with Inflammatory Bowel Disease a
Variable	Univariate Logistic Regression		Multivariate Logistic Regression
Variable	OR (CI 95%)	P value	OR (CI 95%)	P value
Age	1.031 (1.019-1.044)	< 0.001	0.997 (0.974 - 1.021)	0.830
Male Gender	0.583 (0.399-0.852)	0.005	0.60 (0.376-0.959)	0.033
Area Deprivation Index (ADI) b	0.928 (0.859-1.003)	0.058	0.973 (0.880-1.075)	0.590
Offering of vaccine by medical assistants prior to the visit	1.059 (1.059-2.364)	0.025	1.408 (0.849 - 2.335)	0.185
Receiving ≥ 3 COVID-19 vaccines	9.95 (5.87-13.65)	< 0.001	6.510 (4.076-10.399)	< 0.001
Charlson Comorbidity Index (CCI)	1.384 (1.199-1.598)	< 0.001	5.912 (3.599 - 9.712)	< 0.001
Influenza vaccination in 2020–2021	8.424 (5.447-13.03)	< 0.001	1.321 (1.028-1.696)	0.030
Tele-medicine visits only	1.36 (0.93-1.98)	0.112	-	-
Type of IBD	1.16 (0.795-1.699)	0.438	-	-
Systemic immunosuppressive therapy c	1.040 (0.710-1.523)	0.840	-	-
a Abbreviations: n, number of subjects in the study; OR, odds ratio; CI, confidence interval; IBD, inflammatory bowel disease b Street-level addresses were used to assign 2018 ADI using the Neighborhood Atlas C Defined as systemic IBD-directed therapy or systemic corticosteroids

Table: a Abbreviations: n, number of subjects in the study; OR, odds ratio; CI, confidence interval; IBD, inflammatory bowel disease
b Street-level addresses were used to assign 2018 ADI using the Neighborhood Atlas
C Defined as systemic IBD-directed therapy or systemic corticosteroids

Disclosures:

Mazen Almasry indicated no relevant financial relationships.

Trevor Schell indicated no relevant financial relationships.

Luke Richard indicated no relevant financial relationships.

Francis Farraye: AbbVie – Advisory Committee/Board Member. Avalo Therapeutics – Advisory Committee/Board Member. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. Fresenius Kabi – Advisory Committee/Board Member. GI Reviewers – Independent Contractor. GSK – Advisory Committee/Board Member. IBD Educational Group – Independent Contractor. Iterative Health – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member. Pharmacosmos – Advisory Committee/Board Member. Sandoz Immunology – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Viatris – Advisory Committee/Board Member.

Mary Hayney: Dynavax – Received research support. GSK – Consultant. Janssen – Grant/Research Support. Sanofi – Received research support. Seqirus – Consultant. Takeda – Received research support.

Freddy Caldera: Arena – Consultant. Celgene – Consultant. GlaxoSmithKline – Consultant. Janssen – Grant/Research Support. Novavax – Grant/Research Support. Takeda – Consultant, Grant/Research Support.

Mazen Almasry, MBBS¹, Trevor Schell, MD¹, Luke Richard, MD¹, Francis A. Farraye, MD, MSc, MACG², Mary Hayney, PharmD, MPH³, Freddy Caldera, DO, MS⁴. P0772 - Does Telemedicine Impact Influenza Vaccine Uptake in Patients With Inflammatory Bowel Disease?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.