Serologic Status of Routine Childhood Vaccines, Cytomegalovirus, and Epstein-Barr Virus in Children With Inflammatory Bowel Disease

• Published in: Inflammatory bowel diseases Vol. 25; no. 7; pp. 1218 - 1226
• Main Authors: deBruyn, Jennifer C C, Soon, Ing Shian, Fonseca, Kevin, Feng, Sharon, Purtzki, Melanie, Goedhart, Caitlin, Kuhn, Susan, Vanderkooi, Otto G, Wrobel, Iwona
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 18.06.2019
• Subjects: Adalimumab; Adolescent; Child; Child, Preschool; Corynebacterium diphtheriae - immunology; Corynebacterium diphtheriae - isolation & purification; Cross-Sectional Studies; Cytomegalovirus; Cytomegalovirus - immunology; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - blood; Cytomegalovirus Infections - immunology; Cytomegalovirus Infections - prevention & control; Cytomegalovirus Infections - virology; Diphtheria - blood; Diphtheria - immunology; Diphtheria - prevention & control; Diphtheria - virology; Epstein-Barr virus; Epstein-Barr Virus Infections - blood; Epstein-Barr Virus Infections - immunology; Epstein-Barr Virus Infections - prevention & control; Epstein-Barr Virus Infections - virology; Female; Follow-Up Studies; Gastrointestinal diseases; Hepatitis B; Herpesvirus 4, Human - immunology; Herpesvirus 4, Human - isolation & purification; Humans; Immunization; Immunosuppressive Agents - therapeutic use; Infant; Inflammatory bowel disease; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - epidemiology; Inflammatory Bowel Diseases - immunology; Inflammatory Bowel Diseases - virology; Influenza; Male; Mumps; Pediatrics; Prognosis; Serologic Tests; Tetanus; Tetanus - blood; Tetanus - immunology; Tetanus - prevention & control; Tetanus - virology; Vaccination; Vaccines; Viral Load - immunology; Viral Vaccines - administration & dosage; Alberta; Canada; vaccine; Epstein-Barr virus; cytomegalovirus; inflammatory bowel disease; serology
• ISSN: 1078-0998; 1536-4844; 1536-4844
• DOI: 10.1093/ibd/izy366

Abstract Background Data on the serologic status of childhood vaccines, cytomegalovirus (CMV) and Epstein-Barr virus (EBV), are limited in inflammatory bowel disease (IBD). Therefore, we evaluated vaccine coverage and seroprotection, along with CMV and EBV seropositivity, in pediatric IBD. Methods In a cross-sectional study, demographic data, IBD history, vaccine records, and serum for antibodies against measles, mumps, rubella, diphtheria, tetanus, varicella, hepatitis B (HBV), CMV, and EBV were collected from children with IBD. We evaluated potential factors associated with serologic status. Results Of 156 subjects, vaccine coverage was up to date for age in 93.5% for measles, mumps, rubella, 95.6% for diphtheria, tetanus, pertussis, polio, hemophilus influenza B, 75.8% for HBV, and 93.5% for varicella, including past infection and vaccination. Seroprotection was present in 65.8% for measles, 60.5% for mumps, 79.1% for rubella, 79.5% for diphtheria, 80.8% for tetanus, 70.5% for varicella, and 62.8% for HBV of subjects. Older age at diagnosis was associated with seroprotection among subjects with complete HBV (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.03–1.39) and rubella series (OR, 1.18; 95% CI, 1.02–1.37). Older age at serum collection was associated with seroprotection among subjects with prior varicella vaccination or infection (OR, 1.69; 95% CI, 1.33–2.15). Only 25.2% and 37.8% demonstrated seropositivity to CMV and EBV, respectively. Among subjects on immunosuppressive medications, 75.3% and 62.4% were seronegative for CMV and EBV, respectively. Conclusions Children with IBD have low serologic protection to childhood vaccines in spite of high vaccine coverage and universal vaccinations. Children with IBD, including a large proportion on immunosuppressive medications, have low seropositivity to CMV and EBV.