Peer-reviewed article
A 15-year population-based study on incidence and vaccination coverage in pediatric inflammatory bowel disease in Italy.
Francesca Fortunato, Angelo Campanozzi, Michele Di Toma, Alessandra Marinari, Domenico Martinelli ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A 15-year study in Italy's Apulia region tracked cases of inflammatory bowel disease (IBD) in children aged 0-14 years and examined their vaccination rates. The study found that IBD cases increased significantly after 2020, with 1,044 new cases identified between 2009 and 2023. While vaccination coverage for some vaccines like hexavalent and pneumococcal was very high, coverage for other vaccines like rotavirus, meningococcal, human papillomavirus, and influenza was considerably lower. Children with complex chronic conditions had even lower vaccination rates for certain vaccines.
Key points
- 1,044 incident pediatric IBD cases identified over 15 years with average annual incidence of 12.7 per 100,000 children
- Incidence significantly increased after 2020, with peak rates in the 10-14 age group
- Hexavalent and pneumococcal vaccine coverage were very high (100.0% and 99.2%), but rotavirus (82.5%), meningococcal (79.9%), and human papillomavirus coverage were moderate to low
- Influenza vaccination coverage was only 18.9% in 2023/24 season
- Children with complex chronic conditions had lower uptake of measles, mumps, rubella and dTap-IPV booster vaccines
Limitations
The study only covers one region of Italy, so findings may not generalize to other Italian regions or countries. Vaccination coverage analysis was limited to 259 of the 1,044 identified IBD cases, reducing the representativeness of vaccination data.
Abstract
IMPORTANCE: The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide, particularly after the coronavirus disease 2019 pandemic. As children with IBD are at higher risk of infection, adherence to vaccination schedules is essential. However, data on the incidence of IBD and vaccination coverage in Italian children remain limited. OBJECTIVE: To assess the incidence of IBD in children aged 0-14 years in the Apulia region of Italy (2009-2023) and to evaluate their vaccination coverage for both mandatory and recommended vaccines. METHODS: A retrospective population-based study was conducted using hospital discharge records and a user fee exemption registry to identify incident IBD cases. Vaccination history was obtained from the regional immunization system. Age-standardized incidence rates (SIRs) were calculated. Vaccination coverage was assessed based on the receipt of all age-appropriate vaccines according to regional immunization schedules. RESULTS: Between 2009 and 2023, 1044 incident pediatric IBD cases were identified, with an average annual SIR of 12.7/100 000. A significant increase in incidence occurred after 2020 (P < 0.001), peaking in the 10-14 age group. Among the 259 patients assessed for vaccination coverage, the rates were high for hexavalent (100.0%) and pneumococcal vaccines (99.2%), moderate for rotavirus (82.5%) and meningococcal vaccines (79.9%), and lower for human papillomavirus (66.3% in females and 52.1% in males) and diphtheria-tetanus-acellular pertussis and inactivated polio vaccines (dTap-IPV) booster (30.2%). Influenza coverage in 2023/24 was 18.9%. Children with complex chronic conditions had lower uptake of measles, mumps, and rubella and dTap-IPV boosters. INTERPRETATION: The incidence of pediatric IBD is increasing in Apulia, whereas vaccination coverage remains below optimal levels. Targeted strategies are needed to enhance immunization in this vulnerable population.