COVID-19 vaccination in adults with inflammatory bowel disease

Megan Lutz; Sarah Lazarus; Freddy Caldera

doi:10.1177/17562848231173130

COVID-19 vaccination in adults with inflammatory bowel disease

Therap Adv Gastroenterol. 2023 May 22:16:17562848231173130. doi: 10.1177/17562848231173130. eCollection 2023.

Authors

Megan Lutz¹, Sarah Lazarus², Freddy Caldera³

Affiliations

¹ School of Medicine & Public Health, Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, 1685 Highland Avenue, Madison, WI 53705, USA.
² School of Medicine & Public Health, Department of Medicine, University of Wisconsin, Madison, WI, USA.
³ School of Medicine & Public Health, Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA.

Abstract

Patients with inflammatory bowel disease (IBD) are not at increased risk of SARS-CoV-2 infection compared to the general population, and most are not at increased risk for severe disease. COVID-19 is nonetheless common, and vaccination is critical. Four safe and efficacious vaccines are now available for the prevention of COVID-19, with most data available for mRNA vaccines. Patients with IBD have a robust humoral response to vaccination with rates of seroconversion exceeding 95% following a two-dose mRNA vaccine series and 99% following a three-dose mRNA series, although those on certain therapies including anti-tumor necrosis factor α agents may have lower antibody concentrations and waning of antibodies over time. Additionally, rates of cell-mediated immune response, even in those patients with IBD who did not have evidence of humoral immunity, are high. Vaccines are safe and have not been associated with flares in disease activity. Gastroenterology providers should take an active role in ensuring patients with IBD are appropriately vaccinated against COVID-19.

Keywords: COVID-19; Crohn’s disease; inflammatory bowel disease; ulcerative colitis; vaccine.

Publication types

Review