SARS-CoV-2 vaccination in patients with inflammatory bowel disease

Ralley E Prentice; Clarissa Rentsch; Aysha H Al-Ani; Eva Zhang; Douglas Johnson; John Halliday; Robert Bryant; Jacob Begun; Mark G Ward; Peter J Lewindon; Susan J Connor; Simon Ghaly; Britt Christensen

doi:10.1002/ygh2.473

SARS-CoV-2 vaccination in patients with inflammatory bowel disease

GastroHep. 2021 Jul;3(4):212-228. doi: 10.1002/ygh2.473. Epub 2021 Jul 23.

Authors

Ralley E Prentice¹, Clarissa Rentsch¹, Aysha H Al-Ani¹, Eva Zhang¹, Douglas Johnson^{2

3}, John Halliday¹, Robert Bryant⁴, Jacob Begun⁵, Mark G Ward^{6

7}, Peter J Lewindon^{8

9}, Susan J Connor^{10

11

12}, Simon Ghaly^{13

14}, Britt Christensen^{1

15}

Affiliations

¹ Department of Gastroenterology The Royal Melbourne Hospital Melbourne VIC Australia.
² Departments of Infectious Diseases and General Medicine The Royal Melbourne Hospital Melbourne VIC Australia.
³ Department of Medicine Royal Melbourne Hospital University of Melbourne Melbourne VIC Australia.
⁴ Department of Gastroenterology The Queen Elizabeth Hospital Adelaide Australia.
⁵ Department of Gastroenterology Mater Hospital Brisbane Australia.
⁶ Department of Gastroenterology Alfred Health Melbourne VIC Australia.
⁷ Monash University Melbourne VIC Australia.
⁸ Department of Gastroenterology Lady Cilento Children's Hospital Brisbane QLD Australia.
⁹ Queensland Children's Medical Research Institute University of Queensland Brisbane QLD Australia.
¹⁰ Department of Gastroenterology & Hepatology Liverpool Hospital Liverpool NSW Australia.
¹¹ South West Sydney Clinical School University of New South Wales Sydney NSW Australia.
¹² Ingham Institute of Applied Medical Research Sydney NSW Australia.
¹³ Department of Gastroenterology St. Vincent's Hospital Sydney Sydney NSW Australia.
¹⁴ St. Vincent's Clinical School University of New South Wales Sydney Sydney NSW Australia.
¹⁵ University of Melbourne Melbourne VIC Australia.

Abstract

Background: The current COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has drastically impacted societies worldwide. Vaccination against SARS-CoV-2 is expected to play a key role in the management of this pandemic. Inflammatory conditions such as inflammatory bowel disease (IBD) often require chronic immunosuppression, which can influence vaccination decisions.

Aim: This review article aims to describe the most commonly available SARS-CoV-2 vaccination vectors globally, assess the potential benefits and concerns of vaccination in the setting of immunosuppression and provide medical practitioners with guidance regarding SARS-CoV-2 vaccination in patients with IBD.

Methods: All published Phase 1/2 and/or Phase 3 and 4 studies of SARS-CoV-2 vaccinations were reviewed. IBD international society position papers, safety registry data and media releases from pharmaceutical companies as well as administrative and medicines regulatory bodies were included. General vaccine evidence and recommendations in immunosuppressed patients were reviewed for context. Society position papers regarding special populations, including immunosuppressed, pregnant and breast-feeding individuals were also evaluated. Literature was critically analysed and summarised.

Results: Vaccination against SARS-CoV-2 is supported in all adult, non-pregnant individuals with IBD without contraindication. There is the potential that vaccine efficacy may be reduced in those who are immunosuppressed; however, medical therapies should not be withheld in order to undertake vaccination. SARS-CoV-2 vaccines are safe, but data specific to immunosuppressed patients remain limited.

Conclusions: SARS-CoV-2 vaccination is essential from both an individual patient and community perspective and should be encouraged in patients with IBD. Recommendations must be continually updated as real-world and trial-based evidence emerges.

Keywords: COVID‐19; Crohn's disease; SARS‐CoV‐2; immunocompromised; immunosuppression; inflammatory bowel disease; ulcerative colitis; vaccination.

Publication types

Review