C0396 - COVID-19 Vaccination Patterns and Associated Disparities Among Inflammatory Bowel Disease and Liver Transplant Populations

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Trevor Schell, MD

University of Wisconsin School of Medicine and Public Health
Madison, WI

Trevor Schell, MD¹, Luke Richard, MD¹, Katharine Tippins, BS¹, Mazen Almasry, MBBS¹, Sarah Lazarus, BS¹, Miguel Mailig, BS¹, Mary Hayney, PharmD, MPH², Freddy Caldera, DO, MS¹
¹University of Wisconsin School of Medicine and Public Health, Madison, WI; ²University of Wisconsin School & Medicine and Public Health, Madison, WI

Introduction: Liver transplant (LT) recipients may be at higher risk of ICU admission and mechanical ventilation from COVID-19 infection; likewise, patients with inflammatory bowel disease (IBD) on corticosteroids may be at higher risk of severe COVID-19. Vaccine uptake is important to prevent adverse outcomes within these populations. The aim of this study was to evaluate COVID-19 vaccine uptake and associated disparities in patients with IBD and LT recipients.

Methods: We performed a single-center, retrospective study evaluating COVID-19 vaccine uptake among adult patients with IBD and LT recipients seen in clinic between November 2020–April 2021. Vaccination status as of April 2022 was confirmed using the Wisconsin Immunization Registry. ZIP codes were stratified by urban/rural and advantaged/underserved groupings using the Health Innovation Program toolkit. Underrepresented minority (URM) was defined as American Indian/Alaska Native, Black, Native Hawaiian/Pacific Islander race and/or Hispanic ethnicity. The primary outcome was receipt of three mRNA vaccine doses or the viral vector equivalent. A secondary outcome was fourth dose uptake by those eligible.

Results: One thousand twelve patients with IBD and 579 LT recipients were identified (Table 1). Seven hundred twenty-three (71.4%) patients with IBD and 438 (75.6%) LT recipients received three doses of a COVID-19 mRNA vaccine or the viral vector equivalent (p=0.069). Older individuals were more likely to receive three doses (mean 53.3 (SD 16.8) vs 44.5 (SD 15.8), p< 0.001). URMs were less likely to receive a third dose compared to non-URMs (65.1% vs 73.5%, p=0.059). Rural ZIP code dwellers had statistically significantly lower three-dose uptake than urban counterparts (67.3% vs 75.6%, p=0.001). Those living in underserved ZIP codes showed a trend toward lower three-dose vaccine uptake compared to those residing in advantaged ZIP codes (69.2% vs 76.4%, p=0.098). Fourth dose uptake was higher in LT recipients compared to eligible patients with IBD (28.0% vs 8.7%, p< 0.001).

Discussion: Receipt of three COVID-19 mRNA vaccine doses or the viral vector equivalent is high among patients with IBD and LT recipients. However, definitive age- and geography-related disparities in vaccine uptake exist, with is a trend toward lower vaccine uptake in URMs. Initiatives to improve equity in COVID-19 vaccination among IBD and LT populations are needed.

	Inflammatory Bowel Disease (n=1012)	Liver Transplant (n=579)	p value
Age: mean (SD)	47.2 (16.9%)	57.4 (15.1%)	< 0.001
Gender: n (%)			< 0.001
Male:	535 (34.9%)	354 (61.1%)
Female:	476 (47.0%)	225 (38.8%)
Declined to answer:	1 (< 0.1%)	0 (0%)
Underrepresented minority: n (%)	59 (5.8%)	47 (8.1%)	0.078
Rural ZIP code: n (%)	302 (29.8%)	203 (35%)	0.032
Underserved ZIP code: n (%)	57 (5.6%)	57 (9.8%)	< 0.001

Table: Table 1: Demographic data.
Abbreviations: standard deviation (SD)

Disclosures:

Trevor Schell indicated no relevant financial relationships.

Luke Richard indicated no relevant financial relationships.

Katharine Tippins indicated no relevant financial relationships.

Mazen Almasry indicated no relevant financial relationships.

Sarah Lazarus indicated no relevant financial relationships.

Miguel Mailig indicated no relevant financial relationships.

Mary Hayney: Dynavax – Grant/Research Support. GSK – Advisory Committee/Board Member, Speakers Bureau. Seqirus – Advisory Committee/Board Member. Takeda – Grant/Research Support.

Freddy Caldera: Arena – Consultant. Celgene – Consultant. GlaxoSmithKline – Consultant. Sanofi – Grant/Research Support. Takeda – Consultant, Grant/Research Support.

Trevor Schell, MD¹, Luke Richard, MD¹, Katharine Tippins, BS¹, Mazen Almasry, MBBS¹, Sarah Lazarus, BS¹, Miguel Mailig, BS¹, Mary Hayney, PharmD, MPH², Freddy Caldera, DO, MS¹. C0396 - COVID-19 Vaccination Patterns and Associated Disparities Among Inflammatory Bowel Disease and Liver Transplant Populations, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.