Abstract Background Preventative care in inflammatory bowel disease (IBD) is essential to reduce disease- and therapy-related risks. Influenza vaccination (amongst others) is routinely recommended1, yet uptake in people with IBD remains suboptimal despite known benefits and safety2,3. Barriers may include vaccine hesitancy, limited awareness, and fragmented care. We assessed real-world influenza vaccination uptake in IBD and factors linked to suboptimal adherence. Methods People with IBD eligible for government funded influenza vaccination (individuals aged 5–64 years with immunosuppression and all ≥65 years) were included. De-identified data from the Crohn’s Colitis Care clinical quality registry (15 clinical sites across Australia and New Zealand) were analysed in October 2025. Results Eligibility was assessed in 6539 people, of whom 3629 (mean age 43.2, 53.8% male) were eligible for nationally funded influenza vaccination between February to October 2025. Within this cohort, 2331 (64.2%) had Crohn’s Disease (CD), 1210 (33.3%) had ulcerative colitis (UC), and 88 (2.4%) had IBD-unclassified (IBD-U). The majority had a disease duration 5 years (67.0%). Influenza vaccination uptake was recorded as 9.5% (range 5.6%-38.7% across individual sites, mean 12.8%) in this cohort with no significant differences between CD, UC, and IBD-U. Rates did not significantly differ between individuals aged ≥65 and those 65 years (p = 0.298). Across a continuous range, a gradual increase in predicted vaccination probability rose approximately 7.5% at age 28 to 11.5% at age 64 (p = 0.006). There was a significant association between socioeconomic status (SEIFA decile) and vaccination uptake (p 0.001), with rates increasing from 6.6% (most disadvantaged) to 17.6% (most advantaged). Similarly, people with post-secondary education were more likely to be vaccinated (13.5%) compared to those without (8.0%) (p = 0.005). Vaccination rates were similar between people residing in metropolitan (9.7%) and non-metropolitan (8.7%) locales. In a logistic regression model, longer disease duration was significantly associated with higher vaccination uptake (OR = 1.023 per year, p = 0.001). The predicted probability of vaccination increased from 8.1% at 3 years to 12.9% at 26 years of disease duration. Conclusion Influenza vaccination uptake and documentation among people with IBD in a real-world Australasian cohort is low, indicating a persistent gap between guidelines and practice. Strategies to ensure awareness of the need for vaccination and enable easy access and documentation are needed. Integrating consumer controlled digital tools into routine care may help address system fragmentation and enhance preventative health adherence and documentation. References: 1. Farraye FA, Melmed GY, Lichtenstein GR, Barnes EL, Limketkai BN, Caldera F, Kane S. ACG clinical guideline update: Preventive care in inflammatory bowel disease. Official journal of the American College of Gastroenterology| ACG. 2025 Jul 1;120(7):1447-73. doi: 10.1016/j.cgh.2024.12.011 2. Xu F, Dahlhamer JM, Terlizzi EP, Wheaton AG, Croft JB. Receipt of preventive care services among US adults with inflammatory bowel disease, 2015–2016. Digestive diseases and sciences. 2019 Jul 15;64(7):1798-808. doi: 10.1007/s10620-019-05494-w 3. Nakafero G, Grainge MJ, Card T, Mallen CD, Van-Tam JS, Abhishek A. Uptake, safety and effectiveness of inactivated influenza vaccine in inflammatory bowel disease: a UK-wide study. BMJ Open Gastroenterology. 2024 Jun 1;11(1). doi: 10.1136/ bmjgast-2024-001370 Conflict of interest: Dr. Chan, Patrick: No conflicts of interest. Wu, Rodger: No conflicts of interest. Knowles, Simon Robert: No conflicts of interest. Connor, Susan Jane: Research Support: Abbvie, Agency for Clinical Innovation, Amgen, BMS, Chiesi, Celltrion, DrFalk, Ferring, Janssen, Medical Research Future Fund, Pfizer, South Western Sydney Local Health District, Sydney Partnership for Health, Research and Enterprise, Takeda and The Leona M and Harry B Helmsley Charitable Trust Ad Boards: Abbvie, Amgen, BMS, Celltrion, Eli Lilly, Ferring, GSK, Janssen, Organon, Pfizer, Takeda Speaker Fees: Abbvie, Cornerstones Health, Dr Falk, Ferring, Janssen, Pfizer, Sandoz, Sydney IBD School, Takeda Educational Support: DrFalk, Sandoz, Takeda Andrews, Jane Mary: Grant: This project is supported from a grant by The Leona M. and Harry B. Helmsley Charitable Trust. The work I will present was funded via CCCure. CCCure’s funding sources include grants for research and payments for data reports from Pharma including AbbVie, J & J, Takeda, Celltrion, Falk, Ferring, BMS, Janssen, Pfizer, Sandoz
Chan et al. (Thu,) studied this question.