Issue 19

Clinical Question

How effective are SARS-CoV-2 vaccines in IBD patients?

Editor’s Bottom Line

SARS-CoV-2 is effective among patients with IBD, and its efficacy is not compromised by IBD therapy.

Reference

Lewis JD, Sandler RS, Brotherton C, et al. Effectiveness of SARS-CoV-2 Vaccination in a Veterans Affairs Cohort of Patients with Inflammatory Bowel Disease with Diverse Exposure to Immunosuppressive Medications. Gastroenterol. 2021;161(3):827–36; https://doi.org/10.1053/j.gastro.2021.05.044

Synopsis

This retrospective study included 14,697 patients with IBD treated at the Veterans Health Administration, 7,321 of whom had received at least one dose of an mRNA SARS-CoV-2 vaccine. Roughly 55% of vaccinated and unvaccinated patients were receiving mesalamine at the time of vaccination, while approximately one-fifth in each group were receiving an anti-tumor necrosis factor (TNF) agent alone, 11% were administered a thiopurine, 4% were receiving combination treatment with an anti-TNF and an immunomodulator, and the remaining patients were receiving ustekinumab, vedolizumab, methotrexate, tofacitinib and/or corticosteroids.

Patients were a median age 68 years, 61.8% had ulcerative colitis and most were white males.

Over a median follow-up of 123 days until April 20, 2021, 1.3% of unvaccinated individuals experienced SARS-CoV-2 infection, compared to 0.2% of partially vaccinated individuals and 0.1% of fully vaccinated individuals. Full vaccination was found to be 80.4% effective by seven days after the second dose, leading to a 69% reduced risk of infection (Hazard Ratio, 0.31; 95% Confidence Interval, 0.17–0.56; p<0.001). The type of IBD medication used and vaccine type administered did not affect vaccine effectiveness.

Details

Study Design: Retrospective cohort

Funding: None

Allocation: Not applicable

Setting: Multicenter

Level of Evidence: 2b

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.