ABSTRACT
Background: According to the international recommendations, patients with inflammatory bowel disease (IBD) should be vaccinated against SARS-CoV-2 at the earliest opportunity to do so. The aim of this study was to assess the morbidity and mortality from COVID-19 in the adult IBD population in Poland with respect to their vaccin-ation status. Method(s): We conducted a retrospective analysis of administrative health claims collected by the National Health Fund, the sole public payer in Poland. We identified adult IBD patients as of December 31th, 2021 who had at least two or more records with K50 or K51 code and two or more prescriptions for IBD drugs reimbursed or else in-testinal surgery preceding the record. The vaccination status in 2021 was assessed using the database maintained by the Ministry of Health. We examined the vaccination process against SARS-CoV-2 among IBD patients along with morbidity and mortality from COVID-19. We conducted a Cox proportional hazard model analysis to determine the hazard ratio of SARS-CoV-2 infection, hospitalization and death in re-spect to the vaccination status during the autumn wave of the COVID-19 pandemic (October-December 2021). Result(s): As of December 31th, 2021 there were 93 068 adult patients diagnosed with IBD. The vaccination rate in IBD patients was significantly higher than in the general population of Poland (72.1% vs those aged 70-79 years (88.2%) [Figure 1]. 87 353 IBD patients were included into the Cox proportional hazard analysis of autumn pan-demic wave, during which there were 4 042 registered COVID-19 cases in IBD population. The peak value of a weekly average of incidence than for unvaccinated ones (13.0/10000). The risk of being infected 0.5-0.57;p<0.001). The cumulative risk of being positively tested for COVID-19 shows Figure 2. The most notable protective effect of vac-cination against SARS-CoV-2 was found in patients aged 60-69 years (HR 0.47;95%CI 0.39-0.55) and in those aged 80 years and above (HR 0.44;95%CI 0.32-0.63). The risk of hospitalization due to COVID-19 was also significantly lower among the vaccinated IBD patients (HR 19 was more than 3 times decreased in vaccinated IBD patients in com-parison to the remaining IBD population (HR 0.29, 95%CI 0.17-0.43, p<0.001) [Table 1]. Conclusion(s): Adult patients with IBD were more likely to get vaccinated against SARS-COV-2 than adults in the general population of Poland. The vaccination significantly decreased the risk of the infection, hospitalization and death due to COVID-19.
ABSTRACT
The elderly population is particularly susceptible to infectious diseases because of the declining immune response with age. The risk is even higher for elders with co-morbidities such as chronic lung diseases, diabetes mellitus, stroke and cancer. Furthermore, an increase in life expectancy in the elderly population results in an increase in adults residing in long stay care homes where cross infection and infectious disease outbreaks occur more frequently. Vaccination is the most effective strategy to prevent infections. Therefore, the elderly is an important target group for vaccination. Vaccination strategies vary among different countries. Nonetheless, most authorities recommend vaccination for the elderly against COVID-19, pneumococcus infection, seasonal influenza and herpes zoster. Some countries also recommend vaccination against diphtheria, tetanus and pertussis. In this chapter, we will review the justifications, efficacy, side effects and contraindications of these vaccines. Many people after retirement like to travel abroad. Vaccines against hepatitis A, encephalitis and meningococcus infection might be necessary and vaccination schedule should be individually modified for elders with cancer and other chronic diseases. Current vaccines are less immunogenic and effective for the elderly when compared with the younger adult population. We will discuss the challenges faced in improving the immune response and enhancing the coverage rate. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.