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Bianchi FP, Polignano M, Carella N, Rotolo O, Curlo M, Mastronardi M. Role of gastroenterologists and healthcare providers in promoting COVID-19 immunization among individuals with inflammatory bowel disease: A systematic review and meta-analysis on a global scale. Hum Vaccin Immunother 2024; 20:2349319. [PMID: 38755111 DOI: 10.1080/21645515.2024.2349319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals with Inflammatory Bowel Disease (IBD) are more susceptible to experiencing severe complications of COVID-19 if infected. Nevertheless, sub-optimal immunization rates have been reported among these patients. Our study aims to assess COVID-19 VH among a global population of patients with IBD and to investigate the role of healthcare professionals, particularly gastroenterologists, in promoting immunization. Twenty-six studies were systematically selected from scientific articles in the MEDLINE/PubMed, WoK, and Scopus databases from January 1, 2020, to September 15, 2023. The pooled prevalence of COVID-19 VH was 27.2% (95%CI = 20.6-34.2%). A significant relationship was evidenced between COVID-19 vaccine compliance and receiving advice from gastroenterologists or healthcare providers (OR = 2.77; 95%CI = 1.79-4.30). By leveraging their knowledge of IBD, familiarity with patient histories, and trusted patient-doctor relationships, gastroenterologists are pivotal in promoting vaccination. This patient-centered care is crucial in increasing vaccine acceptance among individuals with IBD, contributing to better public health outcomes.
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Affiliation(s)
| | - Maurizio Polignano
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Nicola Carella
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Ornella Rotolo
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Margherita Curlo
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
| | - Mauro Mastronardi
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, Castellana Grotte, Italy
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Mastrangeli G, Vernia F, Necozione S, Muselli M, Frassino S, Cesaro N, Latella G, Fabiani L. Vaccine Acceptance in Patients with Inflammatory Bowel Disease: Lessons Learned from the COVID-19 Pandemic. Vaccines (Basel) 2024; 12:551. [PMID: 38793802 PMCID: PMC11125871 DOI: 10.3390/vaccines12050551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/07/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Immunomodulating therapies, which are commonly used in patients with Crohn's disease (CD) and ulcerative colitis (UC), have been linked to an increased risk of contracting opportunistic infectious diseases, the majority of which are preventable through vaccination. Nonetheless, vaccination rates in these patients are suboptimal, and frequently lower than in the general population. The COVID-19 immunization schedule provided a new scenario for investigating vaccine acceptance in patients with inflammatory bowel disease (IBD), with uncertainty and concerns emerging and the number of subjects receiving the third and fourth doses of the vaccine gradually decreasing. This study investigated IBD patients' attitudes towards previous COVID-19 vaccine programs and identified the factors that influence their adherence. It considered demographic and disease-related factors as well as the role of gastroenterologists and primary care physicians (PCPs). METHODS Data were collected through a self-completed questionnaire administered to all adult IBD patients (age > 18) who visited the Gastroenterology, Hepatology, and Nutrition division at the University of L'Aquila (Italy) for a regular follow-up between November 2021 and December 2022. Non-IBD gastroenterological outpatients who visited during the same period were included as a control group. RESULTS A total of 178 patients were included in the analysis. The IBD group consisted of 77 patients, 48.1% with CD and 51.9% with UC; the mean age was 49.5 years and 51.9% were female. Overall, 94.8% of IBD patients had undergone at least one vaccine dose and 79.2% had received two doses, versus 8% of the control group (p < 0.0001). A total of 84.4% of IBD patients reported their propensity towards COVID-19 vaccination, with an average agreement score significantly higher than the controls (p = 0.0044). The trust of IBD patients in the effectiveness of the COVID-19 vaccine (p < 0.0001) and its role in hastening pandemic resolution (p < 0.0001) is strongly related to motivation and propensity. Concerns about the safety of the COVID-19 vaccine in IBD (p = 0.0202) and fear of vaccine-induced flare-ups (p = 0.0192) were reported as the main barriers. No correlation was found between COVID-19 vaccine propensity and clinical features like the type of IBD, years of disease, activity, and ongoing treatment. Regarding the recommendations received from physicians to get vaccinated against COVID-19, IBD patients relied heavily on their gastroenterologists for advice, while the control group relied mainly on their PCPs. CONCLUSIONS The overall positive attitude towards vaccinations reported in our study was better than that observed for other vaccines. The relationship of trust with the gastroenterologist should be used to boost vaccination against other preventable diseases in IBD patients. Our findings add information on the factors influencing vaccine propensity, which can be used to improve current vaccination strategies.
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Affiliation(s)
- Giada Mastrangeli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (S.N.); (M.M.); (L.F.)
| | - Filippo Vernia
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L’Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L’Aquila, Italy; (F.V.); (S.F.); (N.C.)
| | - Stefano Necozione
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (S.N.); (M.M.); (L.F.)
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (S.N.); (M.M.); (L.F.)
| | - Sara Frassino
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L’Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L’Aquila, Italy; (F.V.); (S.F.); (N.C.)
| | - Nicola Cesaro
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L’Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L’Aquila, Italy; (F.V.); (S.F.); (N.C.)
| | - Giovanni Latella
- Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L’Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L’Aquila, Italy; (F.V.); (S.F.); (N.C.)
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (S.N.); (M.M.); (L.F.)
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Costantino A, Michelon M, Noviello D, Macaluso FS, Leone S, Bonaccorso N, Costantino C, Vecchi M, Caprioli F. Attitudes towards Vaccinations in a National Italian Cohort of Patients with Inflammatory Bowel Disease. Vaccines (Basel) 2023; 11:1591. [PMID: 37896993 PMCID: PMC10611209 DOI: 10.3390/vaccines11101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/19/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The vaccination status of patients with inflammatory bowel disease (IBD) should be investigated before starting any treatment, and patients should eventually be vaccinated against vaccine-preventable diseases (VPDs). Patients with IBD may have suboptimal vaccination rates. The aim of this study was to evaluate the vaccination coverage, attitude towards vaccinations, and determinants among an Italian cohort of patients with IBD. METHODS AMICI, the Italian IBD patients' association, sent an anonymous web-based questionnaire in February 2021. Previous vaccination status and patients' attitudes towards vaccinations were recorded. We examined the factors influencing their attitudes using crude and adjusted odds ratios (adjORs) with 95% confidence intervals (CIs). RESULTS Among the 4039 patients invited, 1252 patients (including 729 women, median age 47.7 [37-58]) completed the questionnaire, with a response rate of 25.3%. Respondents declared being vaccinated against tetanus (74.1%), flu (67.7%; last season), MMR (43.3%), HBV (37.1%), pneumococcus (29.1%), meningitis (20%), HAV (16%), VZV (15.3%), and HPV (7.6%). Complete vaccination history was not remembered by 20.7% of the patients. One thousand one hundred and twelve (88.8%) expressed a positive attitude towards vaccination, 91 (7.3%) were indifferent, and 49 (3.9%) reported being opposed to vaccinations. The belief of a possible return of VPDs with a decline in vaccination coverage rates was the factor most strongly related to a positive attitude towards vaccinations (adjOR 5.67, 95% CI 3.45-9.30, p-value < 0.001). CONCLUSIONS A low vaccination rate against some VPDs was found among a national cohort of patients with IBD, despite a generally positive attitude towards vaccinations.
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Affiliation(s)
- Andrea Costantino
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.V.); (F.C.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (M.M.); (D.N.)
| | - Marco Michelon
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (M.M.); (D.N.)
| | - Daniele Noviello
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (M.M.); (D.N.)
| | | | | | - Nicole Bonaccorso
- Department of Health Promotion Sciences—Maternal and Infant Care—Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (N.B.); (C.C.)
| | - Claudio Costantino
- Department of Health Promotion Sciences—Maternal and Infant Care—Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (N.B.); (C.C.)
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.V.); (F.C.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (M.M.); (D.N.)
| | - Flavio Caprioli
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.V.); (F.C.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (M.M.); (D.N.)
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Principi M, Macaluso FS, Todeschini A, Facciotti F, Contaldo A, Castiglione F, Nardone OM, Spagnuolo R, Doldo P, Riguccio G, Conforti FS, Viganò C, Ascolani M, Fiorino G, Correale C, Bodini G, Milla M, Scardino G, Vernero M, Desideri F, Caprioli F, Mannino M, Rizzo G, Orlando A. Safety, hesitancy of coronavirus disease 2019 vaccination and pandemic burden in patients with inflammatory bowel disease: data of a national study (ESCAPE-IBD). Eur J Gastroenterol Hepatol 2023; 35:629-634. [PMID: 37115976 DOI: 10.1097/meg.0000000000002550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND AND AIMS The purpose of this study was to present data on the safety of anti- severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in a cohort of inflammatory bowel disease (IBD) patients of an ongoing multicenter study (ESCAPE-IBD) sponsored by the Italian Group for the study of Inflammatory Bowel Disease (ClinicalTrials.gov Identifier: NCT04769258). METHODS Anti-SARS-CoV-2 vaccination was administrated to 809 IBD patients. Interviews were conducted to report adverse events related to vaccination. Of these 809, 346 patients were surveyed on the pandemic burden and the main reason for hesitancy in coronavirus disease 2019 vaccination. The chi-square test was used to compare categorical variables. Logistic regression was used to assess the relationship between disease-related characteristics and the onset of adverse events. RESULTS About 45% of patients had at least one side effect, following the first dose (10%), the second (15%), and both doses (19%). All the adverse events were mild and lasted only a few days. Logistic regression analysis revealed that female sex ( P < 0.001), younger age ( P = 0.001), seroconversion ( P = 0.002), and comorbidity ( P < 0.001) were significantly associated with adverse events. The survey showed that the main concerns were the possibility of adverse event (33%). Almost all patients (99%) felt safer having been vaccinated at their IBD reference center. CONCLUSION The vaccine reactions experienced in IBD patients were mostly self-limited. We found high acceptance and good safety of SARS-CoV-2 vaccination in our cohort.
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Affiliation(s)
| | | | | | - Federica Facciotti
- Dipartimento di Oncologia Sperimentale, Istituto Europeo di Oncologia IRCCS, Milan
| | | | - Fabiana Castiglione
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Napoli
| | - Olga Maria Nardone
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Napoli
| | - Rocco Spagnuolo
- Dipartimento di Medicina Sperimentale e Clinica, Università 'Magna Graecia' Catanzaro, U.O. Gastroenterologia ed Endoscopia Digestiva, A.O.U. 'Mater Domini', Catanzaro
| | - Patrizia Doldo
- Dipartimento di Medicina Sperimentale e Clinica, Università 'Magna Graecia' Catanzaro, U.O. Gastroenterologia ed Endoscopia Digestiva, A.O.U. 'Mater Domini', Catanzaro
| | - Gaia Riguccio
- UOSD Malattie Infiammatorie Croniche intestinali, Ospedale Santa Maria del Prato, Feltre
| | - Francesco Simone Conforti
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano, Milan
| | - Chiara Viganò
- Department of Medicine and Surgery, Division of Gastroenterology and Center for Autoimmune Liver Diseases, University of Milano-Bicocca, Monza
| | | | - Gionata Fiorino
- Dipartimento di Gastroenterologia ed Endoscopia Digestiva, IRCCS Ospedale San Raffaele e Università Vita-Salute San Raffaele, Milano
| | | | - Giorgia Bodini
- IRCCS Policlinico San Martino, Università di Genova, Genoa
| | - Monica Milla
- IBD Referral Center, Gastroenterology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence
| | | | - Marta Vernero
- Department of Medical Sciences, Gastroenterology Unit, University of Pavia, Pavia
| | | | - Flavio Caprioli
- Department of Medicine and Surgery, Division of Gastroenterology and Center for Autoimmune Liver Diseases, University of Milano-Bicocca, Monza
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Hu S, Liu J, Li S, Wu Q, Wang X, Xu D, Chen Y. Patients with IBD have a more cautious attitude towards COVID-19 vaccination. Front Immunol 2023; 13:1077308. [PMID: 36741375 PMCID: PMC9889360 DOI: 10.3389/fimmu.2022.1077308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Background To understand the awareness of COVID-19 vaccine, the willingness to vaccinate and the influencing factors of willingness to vaccinate in inflammatory bowel disease (IBD) patients. Methods The online questionnaire was distributed to conduct a survey to analyze and evaluate the willingness, awareness and trust in vaccines of IBD patients. Bivariate analyses and logistic regression models were used to analysis influencing factors. Results We sent the questionnaire to the WeChat group for patient management and 304 patients responded, out of which 16 respondents had to be excluded and 288 respondents were included for the analysis. Among them, 209 patients vaccinated with COVID-19 vaccine. Among the non-vaccinated 79 patients, the main reasons for their concerns were afraid of vaccination aggravating IBD and fear of adverse effects. Our results showed that IBD patients with long disease duration were more willing to receive COVID-19 vaccination (P<0.05). We also observed that a high perception of benefits and cues to action to receive the vaccine were the two most important constructs affecting a definite intention for COVID-19 vaccination (P<0.05). Conclusions Patients with IBD have a more cautious attitude towards COVID-19 vaccination, which may lead to a higher rate of vaccine hesitancy. Further efforts should be made to protect patients with IBD from COVID-19 infections and achieve adequate vaccination coverage.
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Affiliation(s)
- Shurong Hu
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingwen Liu
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuyan Li
- Department of Nursing, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiangqiang Wu
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoying Wang
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingting Xu
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Chen
- Center of Inflammatory Bowel Disease, Department of Gastroenterology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Yan Chen,
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Muacevic A, Adler JR, Annie FH, Kemper S, Naravadi V. Risk of COVID-19 Infection After Full Immunization in Patients With Inflammatory Bowel Disease on Treatment: A Research Network Analysis. Cureus 2023; 15:e34004. [PMID: 36811056 PMCID: PMC9939048 DOI: 10.7759/cureus.34004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an issue in treating patients with Inflammatory Bowel Disease (IBD) due to concerns for infection risk and poor post-vaccination antibody response. We examined the potential impact of IBD treatments on SARS-CoV-2 infection rates after full immunization against COVID-19. METHODS Patients who received vaccines between January 2020 and July 2021 were identified. The post-immunization Covid-19 infection rate at 3 and 6 months was assessed in IBD patients receiving treatment. The infection rates were compared to patients without IBD. Results: The total number of IBD patients was 143,248; of those (n=9405), 6.6% were fully vaccinated. In IBD patients taking biologic agents/small molecules, no difference in Covid-19 infection rate was found at 3 (1.3% vs. 0.97%, p=0.30) and 6 months (2.2% vs. 1.7%, p=0.19) when compared to non-IBD patients. No significant difference in Covid-19 infection rate was found among patients receiving systemic steroids at 3 (1.6% vs. 1.6%, p=1) and 6 months (2.6% vs. 2.9%, p=0.50) between the IBD and non-IBD cohorts. Conclusions: The COVID-19 immunization rate is suboptimal among IBD patients (6.6%). Vaccination in this cohort is under-utilized and should be encouraged by all healthcare providers.
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7
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Batsiou A, Mantzios P, Piovani D, Tsantes AG, Kopanou Taliaka P, Liakou P, Iacovidou N, Tsantes AE, Bonovas S, Sokou R. SARS-CoV-2 Infection and Outcomes in Children with Inflammatory Bowel Diseases: A Systematic Review. J Clin Med 2022; 11:jcm11237238. [PMID: 36498812 PMCID: PMC9737360 DOI: 10.3390/jcm11237238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
The impact of COVID-19 on pediatric patients with inflammatory bowel disease (PIBD) is still not clear and the knowledge acquired over the last 2 years is still evolving. This study aims to investigate the risk and clinical outcomes of COVID-19 in patients with PIBD. A systematic search of PubMed and Scopus databases was conducted to identify studies published up until September 2022. Out of the 475 articles screened, 14 studies were included in the review. Of the 4006 children with PIBD included, 390 (9.7%) tested positive for COVID-19. Among those with COVID-19, 5.9% (0-16.7%) needed hospitalization, 0.6% (0-1%) were admitted to the pediatric intensive care unit (PICU), and no deaths were reported. Among the included studies, only four presented details regarding patients' symptoms, with 21% (0-25%) presenting gastrointestinal (GI) symptoms. An association between PIBD activity or specific treatment and COVID-19 outcome could not be established. The prevalence of COVID-19 in patients with PIBD was low; therefore, the initial concerns regarding higher infection risk and worse prognosis in this population are not supported by the currently available data. Further research is needed to determine the natural history of the infection and the optimal treatment for these patients. Much is still unclear and additional studies should be performed in order to optimize prevention and care for this special group of patients.
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Affiliation(s)
- Anastasia Batsiou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
| | - Petros Mantzios
- Department of Internal Medicine, General Hospital of Eastern Achaia, 25100 Aigio, Greece
| | - Daniele Piovani
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
| | - Andreas G. Tsantes
- Microbiology Department, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece
| | | | - Paraskevi Liakou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Argirios E. Tsantes
- Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Stefanos Bonovas
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- Correspondence: (S.B.); (R.S.)
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Correspondence: (S.B.); (R.S.)
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Zhang E, Christensen B, Macrae FA, Leong R. The Effects of the COVID Pandemic on Patients with IBD: Lessons Learned and Future Directions. J Clin Med 2022; 11:jcm11237002. [PMID: 36498577 PMCID: PMC9740633 DOI: 10.3390/jcm11237002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic has caused extended global disruption and changed healthcare behaviour and delivery in patients with inflammatory bowel disease, many of whom take immune modifying treatment. Although there were fears about the vulnerability of IBD patients to SARS-CoV-2 infection, we have learnt that overall IBD patients are equivalent to the general population in both viral acquisition and infection outcomes. Overall IBD patients obtain effective vaccine-induced immune responses, although in some groups an additional vaccine dose is required to constitute a primary course. The pandemic has led to significant changes in healthcare delivery, some of which will be enduring. As we grapple with the challenges of recovery, the lessons learnt will continue to be important in optimising outcomes in future outbreaks.
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Affiliation(s)
- Eva Zhang
- Department of Medicine, Macquarie University, Macquarie Park 2113, Australia
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
| | - Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
- Department of Medicine, University of Melbourne, Melbourne 3050, Australia
| | - Finlay Alistair Macrae
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
- Department of Medicine, University of Melbourne, Melbourne 3050, Australia
- Department of Colorectal Medicine, Royal Melbourne Hospital, Melbourne 3050, Australia
| | - Rupert Leong
- Department of Medicine, Macquarie University, Macquarie Park 2113, Australia
- Department of Gastroenterology, Concord Repatriation General Hospital, Concord 2137, Australia
- Correspondence:
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Kwon HJ, Panagos K, Alizadeh M, Bell M, Bourmaf M, Zisman E, Paul P, Sibel L, Wong U. Patients with inflammatory bowel disease are more hesitant about Coronavirus disease 2019 vaccination. Front Med (Lausanne) 2022; 9:1005121. [PMID: 36457565 PMCID: PMC9707735 DOI: 10.3389/fmed.2022.1005121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the impact of the Coronavirus Disease 2019 (COVID-19) pandemic, vaccine hesitancy remains common in the general public and patients with Inflammatory Bowel Diseases (IBD). We sought to examine the reasons for vaccine hesitancy in patients with IBD. In this case-control study, we performed a retrospective chart review of 1,349 IBD patients and 215 non-IBD patients seen at University of Maryland Medical Center, a tertiary referral medical center, between March 2020 and October 2021. Data obtained included demographics, vaccination records, disease history, number of IBD-related surgeries, and IBD medications. 813/1,349 (60.3%) IBD patients received at least one dose of either the Pfizer/BioNTech, Moderna, or Johnson & Johnson vaccines. In a multivariate logistic regression, COVID vaccination was found to be positively associated with older age (p-value = 1.65e-5), female sex (p = 0.00194), Asian and White races (p = 0.02330, 0.00169), number of clinic visits (p = 1.11e-08), and biologic use (p = 7.82e-5). There was no association between vaccination and other types of vaccination nor with the use of other IBD medications. There was a negative association between vaccination status and the total number of IBD related surgeries (p = 0.02857). In non-IBD patients, only the number of clinic visits was positively associated with COVID-19 vaccination. Although the majority of IBD patients are immunosuppressed, COVID-19 vaccination rate was only 60.3%. Younger adults, males, African Americans, and those requiring IBD-related surgeries were less likely to receive COVID-19 vaccine. Healthcare providers need to recognize these potential risk factors for COVID-19 vaccine hesitancy.
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Affiliation(s)
- Hyuk Joon Kwon
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Katherine Panagos
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States,*Correspondence: Katherine Panagos
| | - Madeline Alizadeh
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mack Bell
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Mohammad Bourmaf
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Erin Zisman
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Pinkle Paul
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Lauren Sibel
- Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Uni Wong
- Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, United States,Department of Gastroenterology and Hepatology, Veterans Affairs Maryland Health Care System, Baltimore, MD, United States
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Misconceptions Drive COVID-19 Vaccine Hesistancy in Individuals with Inflammatory Bowel Disease. Can J Gastroenterol Hepatol 2022; 2022:4527844. [PMID: 36124090 PMCID: PMC9482530 DOI: 10.1155/2022/4527844] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Vaccination is an effective public health measure to combat the SARS-CoV-2 pandemic. However, vaccine "hesitancy" has limited uptake in some, including inflammatory bowel disease (IBD) patients who may have unique concerns influencing uptake. AIM The aim of the study is to explore attitudes, concerns, and the influence of different sources of information on COVID-19 vaccine uptake in IBD patients. METHODS Patients from a specialist IBD clinic at a tertiary hospital in Australia and a national IBD patient society were invited to complete an anonymous online survey regarding COVID-19 vaccination. Demographic characteristics, attitudes towards vaccination, and trust in sources of information were explored. Logistic regression was used to identify variables associated with vaccine uptake. RESULTS Of 441 respondents, 93% of respondents had received at least 1 dose of COVID-19 vaccination. Self-perceived risk of being more unwell with COVID-19 infection due to IBD (AOR 5.25, 95% CI 1.96-14.04, p < 0.001) was positively associated with vaccine uptake. Concerns regarding the safety of vaccination in pregnancy (OR 0.22, 95% CI 0.08-0.65, p=0.006) and of causing an IBD flare (OR 0.28, 95% CI 0.10-0.77, p=0.01) were negatively associated with vaccine uptake. In total, 282 (73.7%) responders ranked healthcare workers the most trusted source to obtain information surrounding vaccination. CONCLUSION Vaccine hesitancy in IBD patients is low. Concerns about the safety of vaccination in pregnancy and in causing an IBD flare are both associated with vaccine hesitancy. Healthcare providers play a key role in proactively addressing these misconceptions particularly in the context of emerging virus variants and the availability of boosters.
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Tabesh E, Soheilipour M, Rezaeisadrabadi M, Zare-Farashbandi E, Mousavi-Roknabadi RS. Comparison the effects and side effects of Covid-19 vaccination in patients with inflammatory bowel disease (IBD): a systematic scoping review. BMC Gastroenterol 2022; 22:393. [PMID: 35987619 PMCID: PMC9392501 DOI: 10.1186/s12876-022-02460-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Covid-19 is a pandemic disease that is more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. We focused on the research studies on the effect and side effects of Covid-19 vaccination in patients with IBD. Articles were excluded if they were not relevant, or were performed on other patients excerpt patients with IBD. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: (1) the effect of vaccination, and (2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 and its resulting mortality with a high success rate. They should be also mentioned in booster doses. Studies showed that the risk of developing Covid-19 is more worrying in people with immunocompromised conditions, such as inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The results of this systematic scoping review revealed that patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect these patients from the serious complications of Covid-19. Also, they should be also mentioned in booster doses.
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Costantino A, Michelon M, Roncoroni L, Doneda L, Lombardo V, Costantino C, Vecchi M, Elli L. Vaccination Status and Attitudes towards Vaccines in a Cohort of Patients with Celiac Disease. Vaccines (Basel) 2022; 10:vaccines10081199. [PMID: 36016087 PMCID: PMC9413071 DOI: 10.3390/vaccines10081199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: The identification of vaccination status and attitudes towards vaccines among celiac disease (CD) patients is of great importance, but it has not yet been investigated. The aim of this study was to investigate coverage against vaccine-preventable diseases (VPDs), attitudes towards vaccinations, and its determinants among CD patients. (2) Methods: An anonymous web-based validated questionnaire was sent to a mailing list of CD adult patients. Patients were asked to self-report their previous vaccinations and attitudes towards vaccinations, which were defined as positive, negative, and partially positive/negative. The influencing factors towards vaccinations were investigated, and crude and adjusted odds ratios (AdjORs) with 95% confidence intervals (CIs) were calculated. (3) Results: The questionnaire was sent to 412 patients, with a response rate of 31.6% (130 patients, 105 women, median age 40 years, interquartile range 36–51). Patients self-reported vaccination against the following diseases: 73.8% tetanus, 42.3% flu, 20% measles, mumps and rubella, 19.2% meningitis, and 16.2% pneumococcus. Thirty-two people (24.6%) did not remember all of their previous vaccinations. In total, 104 (80%) respondents had a positive attitude towards vaccines, 25 (19.2%) a partially positive/negative one, and 1 a negative one. The determinants significantly influencing the positive attitude were being a graduate (AdjORs 7.49) and a belief in the possible return of VPDs with declining vaccination coverage rates (AdjORs 7.42), while the use of complementary and alternative medicines (AdjORs 0.11) and past negative experience (AdjORs 0.16) were associated with a negative attitude. (4) Conclusions: Despite four out of five CD patients showing a strong positive attitude towards vaccinations, one out of five had a partially negative one. Only a minority (16–20%) reported being vaccinated against some VPDs potentially harmful to their CD because of hyposplenism, such as meningitis and pneumococcus. The low vaccination rate against some VPDs, in spite of the 80% of CD patients stating a positive attitude towards vaccination, may be explained in part by patients’ vaccine hesitancy and in part by a possible role of physicians in under-prescribing vaccinations to these patients. These results may be a starting point for developing specific vaccination campaigns to increase vaccination rates against VPDs in CD patients.
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Affiliation(s)
- Andrea Costantino
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.L.); (M.V.); (L.E.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Correspondence: ; Tel.: +39-025-503-519-1
| | - Marco Michelon
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Leda Roncoroni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (L.R.); (L.D.)
| | - Luisa Doneda
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (L.R.); (L.D.)
| | - Vincenza Lombardo
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.L.); (M.V.); (L.E.)
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, 90145 Palermo, Italy;
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.L.); (M.V.); (L.E.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Luca Elli
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.L.); (M.V.); (L.E.)
- Center for Prevention and Diagnosis of Celiac Disease, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Shehab M, Alrashed F, Alfadhli A. COVID-19 Vaccine Booster Dose Willingness among Patients with Inflammatory Bowel Disease on Infliximab and Vedolizumab: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10081166. [PMID: 35893815 PMCID: PMC9331669 DOI: 10.3390/vaccines10081166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive a third (booster) dose among patients with inflammatory bowel disease (IBD). Methods: A cross-sectional study was performed at an IBD tertiary care center. Patients were recruited at the infusion room from 1 January 2022 to 31 March 2022. The primary outcome was the prevalence of a third (booster) dose of the BNT162b2 vaccine in infliximab- or vedolizumab-treated patients with IBD. The secondary outcome evaluated whether the prevalence of a third (booster) dose of the BNT162b2 vaccine differed based on type of COVID-19 vaccine, gender, age, type of biologic therapy, and citizenship. Results: In total, 499 patients with IBD were included in this study. The median age was 34.5 years, and 60% had ulcerative colitis (UC). Among the study participants, 302 (60.5%) patients were vaccinated with BNT162b2, and 197 (39.5%) were vaccinated with ChAdOx1 nCoV-19. Of the total number of participants, 400 (80.2%) were receiving infliximab, and 99 (19.8%) were receiving vedolizumab. Overall, 290 (58.1%) of the included patients were willing to receive the third (booster) dose. Patients vaccinated with BNT162b2 were more likely to be willing to receive a booster dose compared to patients vaccinated with ChAdOx1 nCoV-19 (201 (66.5%) vs. 103 (52.0%), p = 0.014). Infliximab-treated patients were more likely to be willing to receive a booster dose compared to patients receiving vedolizumab (310 (77.5%) vs. 62 (62.6%), p = 0.002). There was no statistical difference in willingness to receive a booster dose in terms of age, nationality, or gender. Conclusions: The percentage of patients with IBD willing to receive or having already received a third (booster) dose of BNT162b2 vaccine was lower compared to the general population. In addition, patients who received two doses of BNT162b2 vaccines were more likely to be willing to receive a third (booster) dose compared to patients who received ChAdOx1 nCoV-19. Patients treated with infliximab were more likely to be willing to receive a third (booster) dose of COVID-19 vaccine.
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Affiliation(s)
- Mohammad Shehab
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya 46300, Kuwait;
- Correspondence: ; Tel.: +965-99633181
| | - Fatema Alrashed
- Department of Pharmacy Practice, Faculty of Pharmacy, Health Sciences Center (HSC), Kuwait University, Jabriya 46300, Kuwait;
| | - Ahmad Alfadhli
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya 46300, Kuwait;
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Ten Actions to Counteract Vaccine Hesitancy Suggested by the Italian Society of Hygiene, Preventive Medicine, and Public Health. Vaccines (Basel) 2022; 10:vaccines10071030. [PMID: 35891193 PMCID: PMC9320096 DOI: 10.3390/vaccines10071030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/01/2023] Open
Abstract
Vaccine hesitancy (VH) is one of the main causes of the widespread decline in vaccination coverage and has become the subject of ongoing debate among public health professionals. The present commentary is a “decalogue” of strategic actions to counteract vaccine hesitancy for public health professionals that comes from the cognitive and formative path put in place by the “Communication in Public Health” working group (WG) of the Italian Society of Hygiene, Preventive Medicine, and Public Health. From the establishment of a national, multidisciplinary WG on VH to the activation of a national monitoring/surveillance system on vaccine hesitancy, several proposals are discussed. The identification and dissemination of good practices and tools to counteract and understand vaccine hesitancy, interdisciplinary training on vaccine hesitancy and on risk communication, community engagement and infodemiology, the inclusion of effective interventions to counteract vaccine hesitancy within the National Immunization Plan (NIP), the promotion and growth of a community of practice and research in the field of vaccine hesitancy, collaborations between scientific societies, and knowledge from the behavioral sciences represent other actions recommended in the present commentary. The present document suggests ten undeferrable strategies that could be implemented at the national and local levels in Italy, and that could be borrowed by other European countries in order to counteract vaccines hesitancy with a systematic and organic approach.
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James D, Jena A, Bharath PN, Choudhury A, Singh AK, Sebastian S, Sharma V. Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis. Dig Liver Dis 2022; 54:713-721. [PMID: 35382972 PMCID: PMC8938236 DOI: 10.1016/j.dld.2022.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Risk of adverse effects and flare of inflammatory bowel disease (IBD) are frequently cited reasons for COVID-19 vaccine hesitancy. METHODS Electronic databases were searched to identify studies reporting the use of COVID-19 vaccine in IBD. We selected studies reporting the incidence of various adverse effects (local or systemic) and flares of IBD after COVID-19 vaccination. The pooled incidence rates for various adverse effects, stratified for the dose and the type of vaccine (adenoviral or mRNA) were estimated. RESULTS Nine studies (16 vaccination cohorts) were included. The pooled incidence rate of overall adverse events was 0.55 (95%CI, 0.45-0.64, I2= 95%). The pooled incidence rate of local adverse events was 0.64 (0.47-0.78, I2= 100%). The pooled incidence rates of fatigue, headache, myalgia, fever and chills were 0.30 (0.21-0.40, I2= 99%), 0.23 (0.17-0.30, I2= 99%), 0.18 (0.13-0.24, I2= 99%), 0.10 (0.06-0.17, I2= 98%) and 0.15 (0.06-0.3, I2= 86%), respectively. The pooled incidence rates of severe adverse events, adverse events requiring hospitalization and flares of IBD following COVID-19 vaccination were 0.02 (0.00-0.12, I2= 97%), 0.00 (0.00-0.01, I2= 27%) and 0.01 (0.01-0.03, I2= 45%), respectively. CONCLUSION COVID-19 vaccination in patients with IBD appears to be safe with only mild adverse events. Flares of IBD and severe adverse events requiring hospitalization were infrequent.
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Affiliation(s)
- Deepak James
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuraag Jena
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pardhu Neelam Bharath
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arup Choudhury
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam K. Singh
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Corresponding author
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Kubas A, Malecka-Wojciesko E. COVID-19 Vaccination in Inflammatory Bowel Disease (IBD). J Clin Med 2022; 11:jcm11092676. [PMID: 35566802 PMCID: PMC9104993 DOI: 10.3390/jcm11092676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/19/2022] [Accepted: 05/06/2022] [Indexed: 12/12/2022] Open
Abstract
Vaccines against SARS-CoV-2 are believed to play a key role in the suppression of the COVID-19 pandemic. However, patients suffering from inflammatory bowel diseases (IBD) were excluded from SARS-CoV-2 vaccines trials. Therefore, concerns regarding vaccination efficacy and safety among those patients were raised. Overall, vaccination is well tolerated in the IBD population, and different gastroenterological societies recommend vaccinating patients with IBD at the earliest opportunity to do so. Nevertheless, very little is known about the safety of COVID-19 vaccines in special IBD populations such as pregnant and breastfeeding women or pediatric patients, and further research on this matter is crucial. The available data on vaccine efficacy are promising and show high seroconversion rates in IBD patients on different immune-modifying therapies. However, patients treated with high doses of systemic corticosteroids, infliximab or infliximab and immunomodulators may have a blunted response to the vaccination. The data on COVID-19 vaccination willingness among patients with IBD are conflicting. Nevertheless, vaccine effectiveness and safety are reported to be the most common reasons for hesitancy. This review examines the effectiveness and safety of COVID-19 vaccines and describes vaccination willingness and the reasons for potential hesitancy among patients with IBD.
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Le Cosquer G, Grangeon L, Rivière P, Berger A, Zerbib F, Laharie D, Poullenot F. A single dedicated vaccination visit improves vaccination coverage of patients with inflammatory bowel disease. Therap Adv Gastroenterol 2022; 15:17562848221082879. [PMID: 35493617 PMCID: PMC9039447 DOI: 10.1177/17562848221082879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/07/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Patients treated with biologics for inflammatory bowel disease (IBD) have an increased risk of severe infections. Real-life vaccination coverage in this population remains low despite international vaccination guidelines. The aim of this study was to evaluate the impact of a dedicated vaccination visit on vaccination coverage. METHODS A dedicated vaccination visit was offered to all patients admitted for an infusion of a biologic in a tertiary IBD center during a 4-week period. At baseline, vaccination status was collected. Patients received specific information on recommended vaccinations. Perceived utility of both vaccination and the dedicated visit were assessed by visual analogue scale (VAS). Vaccination coverage was reassessed 6 months later by phone call. RESULTS Among the 207 patients analyzed (1 patient declined), rates of vaccination at baseline and 6 months later against diphtheria were 52.7% and 68.6% (p < 0.001), tetanus 55.1% and 70% (p < 0.001), poliomyelitis 51.7% and 68.6% (p < 0.001), pertussis 33.3% and 51.2% (p < 0.001), hepatitis B virus (HBV) 61.4% and 66.7% (p < 0.01), pneumococcus 15.5% and 42.0% (p < 0.001), influenza 29.5% and 36.2% (p < 0.01), and meningococcus C 11.6% and 13.0% (p = 0.083), respectively. A quarter of the patients declined at least one recommended vaccination after the visit. The main reason for this refusal was distrust toward one or more vaccines. CONCLUSION A single visit dedicated to vaccination significantly increases rates of vaccination in patients with IBD treated with biologics.
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Affiliation(s)
- Guillaume Le Cosquer
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
| | - Lionel Grangeon
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
| | - Pauline Rivière
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
| | - Arthur Berger
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
| | - Frank Zerbib
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
| | - David Laharie
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d’Hépato-gastroentérologie et oncologie digestive, Université de Bordeaux, Bordeaux, France
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Mungmunpuntipantip R, Wiwanitkit V. Response to: COVID-19 Vaccination, Willingness, Hesitancy, and Inflammatory Bowel Diseases. Inflamm Bowel Dis 2022; 28:e45. [PMID: 35362517 DOI: 10.1093/ibd/izab279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Shehab M, Zurba Y, Al Abdulsalam A, Alfadhli A, Elouali S. COVID-19 Vaccine Hesitancy among Patients with Inflammatory Bowel Disease Receiving Biologic Therapies in Kuwait: A Cross-Sectional Study. Vaccines (Basel) 2021; 10:55. [PMID: 35062716 PMCID: PMC8777753 DOI: 10.3390/vaccines10010055] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. METHODS A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. RESULTS The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn's disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn's disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). CONCLUSION The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them.
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Affiliation(s)
- Mohammad Shehab
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Aljabreyah 46300, Kuwait; (Y.Z.); (A.A.A.); (A.A.)
| | - Yasmin Zurba
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Aljabreyah 46300, Kuwait; (Y.Z.); (A.A.A.); (A.A.)
| | - Ali Al Abdulsalam
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Aljabreyah 46300, Kuwait; (Y.Z.); (A.A.A.); (A.A.)
| | - Ahmad Alfadhli
- Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Aljabreyah 46300, Kuwait; (Y.Z.); (A.A.A.); (A.A.)
| | - Sara Elouali
- Department of Internal Medicine, Cleveland Clinic, Abu Dhabi P.O. Box 112412, United Arab Emirates;
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Acceptance of COVID-19 Vaccines among Patients with Inflammatory Bowel Disease in Japan. Healthcare (Basel) 2021; 10:healthcare10010006. [PMID: 35052170 PMCID: PMC8774988 DOI: 10.3390/healthcare10010006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccination is recommended for patients with inflammatory bowel disease (IBD). However, the acceptance of COVID-19 vaccines has not been sufficiently evaluated in patients with IBD. We aimed to assess the acceptance and hesitancy of COVID-19 vaccination and related factors among these patients. A retrospective cohort study using a self-reported questionnaire was performed among patients with IBD between 22 June 2021 and 30 August 2021. Of the 187 participants, 10.2% (n = 19) were hesitant to be vaccinated. Patients in the vaccine-hesitant group were younger (p = 0.009) and had a shorter disease duration (p = 0.020). Vedolizumab was prescribed more frequently (p = 0.024) and immunomodulators were less frequently used (p = 0.027) in this group. Multivariable logistic regression analysis identified age (odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.92-1.00, p = 0.042) and the use of immunomodulators (OR: 0.08, 95% CI: 0.01-0.66, p = 0.019) as independent significant factors for vaccine hesitancy. The COVID-19 vaccine hesitancy rate in patients with IBD in Japan was 10% in this study. The Japanese COVID-19 vaccination campaign appears to be successful. The risk of COVID-19 among patients with IBD requires adequate measures to ensure that vaccines are accepted by vaccine-hesitant patients. These findings may be helpful in achieving adequate vaccination rates.
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Li N, Chu C, Lin W. A Survey of Hesitancy and Response to the COVID-19 Vaccine Among Patients With Epilepsy in Northeast China. Front Neurol 2021; 12:778618. [PMID: 34867767 PMCID: PMC8635519 DOI: 10.3389/fneur.2021.778618] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study was conducted to investigate the hesitancy and response of people with epilepsy (PWE) to the coronavirus disease 2019 (COVID-19) vaccine. Methods: We conducted an online survey among PWE in northeast China about hesitancy and response to the COVID-19 vaccine. Their demographic background and symptomatic data about epilepsy were also recorded, and we analyzed the epilepsy-related risk factors in delaying the vaccine. Results: In total, 357 patients with confirmed epilepsy were included in the survey, and only 38 (11%) patients received the COVID-19 vaccine. Fear of aggravating epilepsy (58%, n = 185), discouragement from health workers for epilepsy (22%, n = 70), and fear of patients of other unknown serious side effects (13%, n = 42) were the main reasons for delaying vaccination. A higher seizure frequency was the only epilepsy-related risk factor in delaying the vaccine (OR = 1.104, 95% CI: 0.988-1.233). None of the vaccinated patients reported that the vaccine aggravated their epilepsy. Significance: Understanding concerns about the COVID-19 vaccine among PWE could help to improve health education and promote the establishment of an immune barrier.
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Affiliation(s)
- Nan Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Chaojia Chu
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
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22
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COVID-19 Vaccine Acceptance among Liver Transplant Recipients. Vaccines (Basel) 2021; 9:vaccines9111314. [PMID: 34835245 PMCID: PMC8619490 DOI: 10.3390/vaccines9111314] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022] Open
Abstract
(1) Background: COVID-19 vaccination hesitancy is a threat for fragile patients. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of liver transplant (LT) recipients. (2) Methods: In February 2021, a questionnaire on COVID-19 vaccines was sent to LT patients followed at our liver transplant outpatient clinic in Milan, Italy. Sociodemographic and clinical characteristics were recorded. Patients were defined as willing, hesitant, or refusing and their reasons were investigated. Associations between baseline characteristics and willingness were evaluated. Since March 2021, when the COVID-19 vaccines became available for LT candidates and recipients in Italy, the entire cohort of LT recipients was contacted by phone and called for vaccination, and the rate of refusals recorded. (3) Results: The web-based survey was sent to 583 patients, of whom 190 responded (response rate of 32.6%). Among the respondents to the specific question about hesitancy (184), 157 (85.3%) were willing to be vaccinated against COVID-19, while 27 (14.7%) were hesitant. Among the hesitant, three were totally refusing, for a refusal rate of 1.6%. Thirteen hesitant patients (48.1%) answered that their COVID-19 vaccination hesitancy was influenced by being a transplant recipient. The fear of adverse effects was the main reason for refusal (81.5%). Of the 711 LT patients followed at our center, 668 got fully vaccinated, while 43 (6.1%) of them refused the scheduled vaccination. (4) Conclusions: Most patients accepted COVID-19 vaccines, although 6.1% refused the vaccine. Since it is crucial to achieve adequate vaccination of LT patients, it is very important to identify the reasons influencing COVID-19 vaccination hesitancy so that appropriate and targeted communication strategies can be established and specific vaccination campaigns further implemented.
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23
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Wu X, Lin J, Buch H, Ding Q, Zhang F, Cui B, Ji G. The COVID-19 Vaccination Hesitancy Among the People With Inflammatory Bowel Disease in China: A Questionnaire Study. Front Public Health 2021; 9:731578. [PMID: 34708016 PMCID: PMC8542757 DOI: 10.3389/fpubh.2021.731578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022] Open
Abstract
Objective: To explore the attitudes and views of patients with inflammatory bowel disease (IBD) on COVID-19 vaccination. Methods: An online interview questionnaire concerning the acceptance or hesitancy toward vaccination for COVID-19 was designed and 543 patients with IBD in China were invited to complete the structured self-administered anonymous questionnaire. Results: Of all the participants, 50.7% were indecisive about the vaccination and only 16.0% opted for it. Vaccination hesitancy was significantly associated with women and those without medical or biomedical backgrounds. The acceptance of COVID-19 vaccination was higher in participants with no history of immune-modifying therapies, especially in those without immunosuppressants. Participants who considered vaccination critically important to self-health or the health of others were more likely to choose immediately or later vaccination. Safety and potential adverse reactions, personal hypoimmunity, efficacy, and reliability of COVID-19 vaccines were the top three concerns of the participants that were independent of their willingness for vaccination. Conclusions: This study discloses the presence of hesitancy for COVID-19 vaccination in patients with IBD. Further studies are warranted to evaluate the efficacy and safety of COVID-19 vaccines in IBD individuals, with a specific focus on the impact of immune-modifying therapies. Health education and recommendation from authoritative sources may facilitate COVID-19 vaccination efforts.
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Affiliation(s)
- Xia Wu
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Jue Lin
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Heena Buch
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Quchen Ding
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Faming Zhang
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Bota Cui
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
| | - Guozhong Ji
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, China
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Montalti M, Di Valerio Z, Rallo F, Squillace L, Costantino C, Tomasello F, Mauro GL, Stillo M, Perrone P, Resi D, Gori D, Vitale F, Fantini MP. Attitudes toward the SARS-CoV-2 and Influenza Vaccination in the Metropolitan Cities of Bologna and Palermo, Italy. Vaccines (Basel) 2021; 9:vaccines9101200. [PMID: 34696308 PMCID: PMC8538834 DOI: 10.3390/vaccines9101200] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022] Open
Abstract
Vaccine hesitancy (VH) is known to play a relevant role in thwarting the efforts toward reaching satisfactory influenza vaccination coverage, and has caused similar difficulties during the COVID-19 pandemic. This study aims to describe the phenomenon and produce insights on the reasons behind VH. A survey was administered between December 2020 and February 2021 to adults living in the cities of Bologna and Palermo. Of the 443 subjects enrolled, 47.3% were likely to get the influenza vaccination, while 75.6% were willing to receive the COVID-19 vaccination. The most frequent determinants that motivated the willingness to get the COVID-19 vaccine were trust in the safety of vaccines and belief that the vaccine is an effective tool. As for people’s unwillingness to be vaccinated, being exposed to information that produced doubts about the vaccine and lack of trust in a newly developed vaccine were the most frequently involved determinants. Statistically significant positive associations were found between the willingness to be vaccinated and postgraduate education and the propensity towards influenza vaccination. A negative association with being over 40 years old and of female gender was also found. These results might have an impact in better understanding individual reasons behind VH, identifying which categories are more exposed to it and which strategies should be implemented.
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Affiliation(s)
- Marco Montalti
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Zeno Di Valerio
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Flavia Rallo
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
- Correspondence: ; Tel.: +39-051-209-4802
| | - Lorena Squillace
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Francesco Tomasello
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological, and Stomatological Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Michela Stillo
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Paola Perrone
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Resi
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Maria Pia Fantini
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
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