University of Wisconsin–Madison Medical College of Wisconsin

Uptake Rates of Three COVID-19 Vaccine Doses and Risk Factors for Incomplete Vaccination Among Patients With Inflammatory Bowel Disease Residing in Wisconsin: A Single-Center Cohort

Trevor L. Schell, MD; Miguel A. Mailig, BS; Mazen Almasry, MBBS; Sarah Lazarus, BS; Luke J. Richard, MD; Katharine Tippins, BS; Jennifer Weiss, MD, MS; Mary S. Hayney, PharmD, MPH; Freddy Caldera, DO, MS

WMJ. 2023;122(5):450-455

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Introduction: Patients with inflammatory bowel disease on systemic corticosteroids may be at higher risk of adverse outcomes of COVID-19 infection, and vaccination is an essential preventive measure. Uptake of the original 2-dose COVID-19 messenger RNA (mRNA) primary vaccine series was previously high among patients with inflammatory bowel disease, while uptake of subsequent doses based on interval recommendations made by the Advisory Committee on Immunization Practice remains unknown. Herein, we evaluated uptake of 3 COVID-19 mRNA vaccine doses among patients with inflammatory bowel disease.

Methods: We performed a single-center, retrospective study evaluating COVID-19 vaccine uptake among adult patients with inflammatory bowel disease residing in Wisconsin who were seen at the University of Wisconsin Digestive Health Center. Vaccination status as of April 30, 2022, was verified in the Wisconsin Immunization Registry. A multivariable logistic regression was performed with the primary endpoint of receipt of 3 COVID-19 vaccine doses. Secondary outcomes included identification of demographic and clinical variables associated with incomplete vaccination.

Results: A total of 1012 patients were identified; 728 (71.9%) patients received 3 COVID-19 vaccine doses. Multivariable logistic regression revealed that younger age (odds ratio [OR] 1.02; 95% CI, 1.01 – 1.03; P = 0.001), rural status (OR 3.44; 95% CI, 2.17 – 5.56; P < 0.001), underrepresented minority status (OR 3.85; 95% CI, 1.89 – 7.69; P < 0.001), and absence of influenza vaccination (OR 8.17; 95% CI, 5.41 – 12.33; P < 0.001) were significantly associated with incomplete COVID-19 vaccination.

Conclusions: Receipt of 3 COVID-19 mRNA vaccine doses is high overall among patients with inflammatory bowel disease. Younger age, underrepresented race/ethnicity, rural status, and lack of influenza vaccination are associated with incomplete COVID-19 vaccination.

Author Affiliations: Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Schell, Almasry, Richard); University of Wisconsin-Madison, School of Pharmacy, Madison, Wis (Mailig); UWSMPH, Madison, Wis (Lazarus, Tippins, Hayney); Department of Internal Medicine, Division of Gastroenterology and Hepatology, UWSMPH, Madison, Wis (Weiss, Caldera).
Corresponding Author: Freddy Caldera, DO, MS, 1685 Highland Ave, Madison, WI 53705-2281; phone 608.263.1995; email; ORCID ID 0000-0003-1960-6611
Funding/Support: None declared.
Financial Disclosures: Dr Weiss has received research support from the Wisconsin Partnership Program and the University of Wisconsin Health Innovation Program. Dr Hayney is a consultant for GSK Vaccines and Seqirus and has received research support from Takeda Pharmaceuticals, Dynavax, and Sanofi. Dr Caldera has received research support from Janssen and Takeda Pharmaceuticals, and he has been a consultant for Takeda, Arena Pharmaceuticals, GSK, and Celgene.
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