Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis

Abstract

Introduction: Risk of adverse effects and flare of inflammatory bowel disease (IBD) are frequently cited reasons for COVID-19 vaccine hesitancy.

Methods: Electronic databases were searched to identify studies reporting the use of COVID-19 vaccine in IBD. We selected studies reporting the incidence of various adverse effects (local or systemic) and flares of IBD after COVID-19 vaccination. The pooled incidence rates for various adverse effects, stratified for the dose and the type of vaccine (adenoviral or mRNA) were estimated.

Results: Nine studies (16 vaccination cohorts) were included. The pooled incidence rate of overall adverse events was 0.55 (95%CI, 0.45-0.64, I²= 95%). The pooled incidence rate of local adverse events was 0.64 (0.47-0.78, I²= 100%). The pooled incidence rates of fatigue, headache, myalgia, fever and chills were 0.30 (0.21-0.40, I²= 99%), 0.23 (0.17-0.30, I²= 99%), 0.18 (0.13-0.24, I²= 99%), 0.10 (0.06-0.17, I²= 98%) and 0.15 (0.06-0.3, I²= 86%), respectively. The pooled incidence rates of severe adverse events, adverse events requiring hospitalization and flares of IBD following COVID-19 vaccination were 0.02 (0.00-0.12, I²= 97%), 0.00 (0.00-0.01, I²= 27%) and 0.01 (0.01-0.03, I²= 45%), respectively.

Conclusion: COVID-19 vaccination in patients with IBD appears to be safe with only mild adverse events. Flares of IBD and severe adverse events requiring hospitalization were infrequent.

Keywords: Crohn's disease; SARS-CoV-2; Side-effect; Ulcerative colitis.