{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:10:05Z","timestamp":1792469405383,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T00:00:00Z","timestamp":1715990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Immunomodulating therapies, which are commonly used in patients with Crohn\u2019s 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\u2019 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 &gt; 18) who visited the Gastroenterology, Hepatology, and Nutrition division at the University of L\u2019Aquila (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 &lt; 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 &lt; 0.0001) and its role in hastening pandemic resolution (p &lt; 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.<\/jats:p>","DOI":"10.3390\/vaccines12050551","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T08:20:31Z","timestamp":1716193231000},"page":"551","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaccine Acceptance in Patients with Inflammatory Bowel Disease: Lessons Learned from the COVID-19 Pandemic"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5715-2632","authenticated-orcid":false,"given":"Giada","family":"Mastrangeli","sequence":"first","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1350-4876","authenticated-orcid":false,"given":"Filippo","family":"Vernia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L\u2019Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Necozione","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Muselli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Frassino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L\u2019Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L\u2019Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-5711","authenticated-orcid":false,"given":"Giovanni","family":"Latella","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Life, Health, and Environmental Sciences, University of L\u2019Aquila, Piazzale S. Tommasi, 1-Coppito, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-1450","authenticated-orcid":false,"given":"Leila","family":"Fabiani","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjz180","article-title":"ECCO Guidelines on Therapeutics in Crohn\u2019s Disease: Medical Treatment","volume":"14","author":"Torres","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1093\/ecco-jcc\/jjx009","article-title":"Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 2: Current Management","volume":"11","author":"Harbord","year":"2017","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1053\/j.gastro.2008.01.012","article-title":"Risk Factors for Opportunistic Infections in Patients With Inflammatory Bowel Disease","volume":"134","author":"Toruner","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.crohns.2012.02.015","article-title":"Infection-related hospitalizations are associated with increased mortality in patients with inflammatory bowel diseases","volume":"7","author":"Ananthakrishnan","year":"2013","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/ibd\/izy243","article-title":"Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease","volume":"25","author":"Tinsley","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1093\/ecco-jcc\/jjab052","article-title":"ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease","volume":"15","author":"Kucharzik","year":"2021","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/ajg.2016.537","article-title":"ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease","volume":"112","author":"Farraye","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"s1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Al-Omar, H.A., Sherif, H.M., and Mayet, A.Y. (2019). Vaccination status of patients using anti-TNF therapy and the physicians\u2019 behavior shaping the phenomenon: Mixed-methods approach. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223594"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.dld.2021.04.015","article-title":"Vaccinations and inflammatory bowel disease\u2014A systematic review","volume":"53","author":"Chan","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/apt.16730","article-title":"Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: Propensity matched research network analysis","volume":"55","author":"Hadi","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Vernia, F., Ashktorab, H., Cesaro, N., Monaco, S., Faenza, S., Sgamma, E., Viscido, A., and Latella, G. (2023). COVID-19 and Gastrointestinal Tract: From Pathophysiology to Clinical Manifestations. Medicina, 59.","DOI":"10.3390\/medicina59101709"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1053\/j.gastro.2021.09.011","article-title":"Impact of Medications on COVID-19 Outcomes in Inflammatory Bowel Disease: Analysis of More Than 6000 Patients From an International Registry","volume":"162","author":"Ungaro","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/jcag\/gwaa046","article-title":"COVID-19 Vaccination in Patients With Inflammatory Bowel Disease: Communiqu\u00e9 From the Canadian Association of Gastroenterology","volume":"4","author":"Tse","year":"2021","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S2468-1253(21)00024-8","article-title":"SARS-CoV-2 vaccination for patients with inflammatory bowel disease: A British Society of Gastroenterology Inflammatory Bowel Disease section and IBD Clinical Research Group position statement","volume":"6","author":"Alexander","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1053\/j.gastro.2021.06.014","article-title":"COVID-19 Vaccination Is Safe and Effective in Patients With Inflammatory Bowel Disease: Analysis of a Large Multi-institutional Research Network in the United States","volume":"161","author":"Hadi","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1016\/j.cgh.2021.02.004","article-title":"COVID-19 Vaccination Intent and Perceptions Among Patients With Inflammatory Bowel Diseases","volume":"19","author":"Dalal","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4165","DOI":"10.1016\/j.vaccine.2015.04.037","article-title":"Measuring vaccine hesitancy: The development of a survey tool","volume":"33","author":"Larson","year":"2015","journal-title":"Vaccine"},{"key":"ref_19","unstructured":"World Health Organization Regional Office for Europe (2023, August 24). COVID-19 Snapshot MOnitoring (COSMO) [Internet]. Available online: https:\/\/www.psycharchives.org\/handle\/20.500.12034\/2397."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1001\/jama.2020.26419","article-title":"National Trends in the US Public\u2019s Likelihood of Getting a COVID-19 Vaccine\u20141 April to 8 December 2020","volume":"325","author":"Szilagyi","year":"2020","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1136\/gutjnl-2020-321244","article-title":"British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic","volume":"69","author":"Kennedy","year":"2020","journal-title":"Gut"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.vaccine.2019.11.056","article-title":"Words matter: Vaccine hesitancy, vaccine demand, vaccine confidence, herd immunity and mandatory vaccination","volume":"38","author":"Dudley","year":"2020","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1111\/j.1572-0241.2006.00646.x","article-title":"Patients with Inflammatory Bowel Disease Are at Risk for Vaccine-Preventable Illnesses","volume":"101","author":"Melmed","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Sallam, M. (2021). COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines, 9.","DOI":"10.1101\/2020.12.28.20248950"},{"key":"ref_25","unstructured":"(2024, January 08). EpiCentro. (n.d.) Coronavirus. Sorveglianza Integrata COVID-19: I Principali Dati Nazionali. [Internet]. Available online: https:\/\/www.epicentro.iss.it\/coronavirus\/sars-cov-2-sorveglianza-dati."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bianchi, F.P., Donghia, R., Tatoli, R., and Bonfiglio, C. (2023). COVID-19 Immunization Rates in Patients with Inflammatory Bowel Disease Worldwide: A Systematic Review and Meta-Analysis. Vaccines, 11.","DOI":"10.3390\/vaccines11101523"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1077308","DOI":"10.3389\/fimmu.2022.1077308","article-title":"Patients with IBD have a more cautious attitude towards COVID-19 vaccination","volume":"13","author":"Hu","year":"2023","journal-title":"Front. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1093\/ibd\/izab172","article-title":"COVID-19 Vaccination Willingness and Hesitancy in Patients With Inflammatory Bowel Diseases: Analysis of Determinants in a National Survey of the Italian IBD Patients\u2019 Association","volume":"28","author":"Costantino","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6500","DOI":"10.1016\/j.vaccine.2020.08.043","article-title":"Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated?","volume":"38","author":"Reiter","year":"2020","journal-title":"Vaccine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s10067-020-05059-7","article-title":"Understanding factors associated with vaccine uptake and vaccine hesitancy in patients with rheumatoid arthritis: A scoping literature review","volume":"40","author":"Boucher","year":"2021","journal-title":"Clin. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Doornekamp, L., Goetgebuer, R.L., Schmitz, K.S., Goeijenbier, M., van der Woude, C.J., Fouchier, R., van Gorp, E.C.M., and de Vries, A.C. (2020). High immunogenicity to influenza vaccination in crohn\u2019s disease patients treated with ustekinumab. Vaccines, 8.","DOI":"10.3390\/vaccines8030455"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1007\/s10620-023-07903-7","article-title":"Interventions Increase Vaccination Rates in Inflammatory Bowel Disease and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis","volume":"68","author":"Patel","year":"2023","journal-title":"Dig. Dis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S0264-410X(01)00307-3","article-title":"Analysis of factors influencing vaccine uptake: Perspectives from Belgium","volume":"20","author":"Swennen","year":"2002","journal-title":"Vaccine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.2147\/PPA.S265346","article-title":"Insufficient knowledge and vaccination practice of inflammatory bowel disease patients in the People\u2019s Republic of China","volume":"14","author":"Feng","year":"2020","journal-title":"Patient Prefer. Adherence"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/1751-2980.12834","article-title":"Insufficient awareness and vaccination practices for inflammatory bowel disease patients in China: A multi-center survey of Chinese gastroenterologists","volume":"21","author":"Li","year":"2020","journal-title":"J. Dig. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1002\/ibd.21667","article-title":"Vaccinating the inflammatory bowel disease patient: Deficiencies in gastroenterologists knowledge","volume":"17","author":"Wasan","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1136\/postgradmedj-2016-134266","article-title":"Vaccination practices in patients with inflammatory bowel disease among general internal medicine physicians in the USA","volume":"93","author":"Gurvits","year":"2017","journal-title":"Postgrad. Med. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1093\/ecco-jcc\/jjac010","article-title":"Implementation and Short-term Adverse Events of Anti-SARS-CoV-2 Vaccines in Inflammatory Bowel Disease Patients: An International Web-based Survey","volume":"16","author":"Ellul","year":"2022","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s10654-020-00671-y","article-title":"Vaccine hesitancy: The next challenge in the fight against COVID-19","volume":"35","author":"Dror","year":"2020","journal-title":"Eur. J. Epidemiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"731578","DOI":"10.3389\/fpubh.2021.731578","article-title":"The COVID-19 Vaccination Hesitancy Among the People With Inflammatory Bowel Disease in China: A Questionnaire Study","volume":"9","author":"Wu","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_41","first-page":"805","article-title":"Recommendations of the Spanish Group on Crohn\u2019s Disease and Ulcerative Colitis on the importance, screening and vaccination in inflammatory bowel disease patients","volume":"45","author":"Piqueras","year":"2022","journal-title":"Gastroenterol. Hepatol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/5\/551\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:44:23Z","timestamp":1760107463000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/5\/551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,18]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["vaccines12050551"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12050551","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,18]]}}}