| Original Article |
Questions: 1) How effective is the COVID-19 vaccine in preventing SARS-CoV-2 infection, particularly in patients using corticosteroids and tumor necrosis factor (TNF) inhibitors? 2) How can COVID-19 vaccinations affect people with inflammatory bowel disease?
Design/Method: A population-based controlled study was conducted. The data from a national IBD database was used to identify patients with IBD (Israeli IBD Research Nucleus (epi-IIRN)). People who received Pfizer-BioNTech BNT162b2 vaccine doses between December 2020 and June 2021 were individually matched to non-IBD controls. To assess IBD outcomes, vaccinated patients to unvaccinated IBD patients were matched, and the response was analyzed per medical treatment
Setting: Israeli
Patients/ Study community: People with IBD who had been vaccinated against COVID-19
| Basic Characteristics of Vaccinated and Unvaccinated IBD Patients | ||||
| Non-vaccinated (n = 707) | Vaccinated (n = 707) | P value | SMD* | |
| Age (y) | 31 ± 13.0 | 31 ± 13.0 | 1 | <0.001 |
| Sex, male | 358 (50.6%) | 358 (50.6%) | 1 | <0.001 |
| Duration of follow-up after second vaccine (weeks) | 14 (2.3–20.4) | 14 (2.3–20.4) | 1 | <0.001 |
| IBD type
CD* UC* |
485 (69%) 222 (31%) |
485 (69%) 222 (31%) |
1 1 |
1 1 |
| Disease duration (y) | 8.6 (5.4–12) | 8.6 (5.4–12) | 1 | <0.001 |
| Treatment over last year
Mesalamine Corticosteroid Immunomodulator Anti-TNF Vedolizumab Ustekinumab Tofacitinib |
94 (13.3%) 23 (3.3%) 25 (3.5%) 95 (13.4%) 18 (2.5%) 8 (1.1%) 1 (0.1%) |
114 (16.1%) 16 (2.3%) 35 (5.0%) 107 (15.1%) 30 (4.2%) 12 (1.7%) 2 (0.3%) |
.154 .330 .235 .403 .106 .499 1.0 |
0.080 0.060 0.070 0.049 0.094 0.048 0.031 |
| IBD hospitalization ever | 271 (38.3%) | 304 (43.0%) | .083 | 0.095 |
| IBD surgery ever | 65 (9.2%) | 94 (13.3%) | .018 | 0.130 |
| Corticosteroids therapy ever | 350 (49.5%) | 376 (53.2%) | .183 | 0.074 |
| *SMD: standardized mean difference, CD: Crohn’s disease, UC: ulcerative colitis | ||||
Results: Pfizer COVID-19 vaccine is equally effective at preventing infection in IBD patients, including those on immunosuppressive medication, as in non-IBD subjects. Vaccinated IBD patients have no more disease exacerbations after vaccination than unvaccinated IBD patients
Commentary:
| The current study offers additional comfort regarding the safety of the COVID-19 vaccination in IBD patients because it is the first significant controlled trial to address the latter result using a broad definition of aggravation. IBD patients were similarly protected by the COVID-19 immunization as were healthy individuals. |
Citation: Raffi Lev-Tzion, Gili Focht, Rona Lujan, and et all. COVID-19 vaccine is effective in inflammatory bowel disease patients and is not associated with disease exacerbation. Clinical Gastroenterology and Hepatology. 2022; 20(6): 1263–1282
DOI: 10.1016/j.cgh.2021.12.026
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697416/
Topics: SARS-CoV-2, Vaccination, Crohn’s Disease, Ulcerative Colitis
