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January 26, 2021
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Patients with IBD should receive COVID-19 vaccine, despite concerns

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Physicians should encourage patients with inflammatory bowel disease to get the COVID-19 vaccination despite lack of studies on the cohort, according to a presentation at the Crohn’s and Colitis Congress.

“For patients with IBD we would advocate, based on [International Organization for the Study of Inflammatory Bowel Disease (IOIBD)], that patients get vaccinated, acknowledging that there is a lack of data specifically in IBD patients,” Ryan C. Ungaro, MD, MS, gastroenterologist with Mount Sinai Hospital’s Feinstein IBD Center, told Healio Gastroenterology. “But we think the benefits out weight the risks and based on prior experience with vaccinations in IBD patients.”

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CDC and IOIBD recommend patients with IBD should receive the COVID-19 vaccine.

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According to Ungaro, the CDC recommended immunocompromised patients should get the COVID-19 vaccine. Patients should be counseled that it is not yet known whether the safety and effectiveness of the vaccine in immunocompromised patients is the same compared with the general population.

“The major concern would be certain medications could lead to decreased response to the vaccine,” he said. “That is something that is going to need to be studied but right now the expert consensus is that IBD patients should get vaccinated against COVID-19.”

According to IOIBD recommendations, patients with IBD should receive the COVID-19 vaccine as soon as possible. Messenger RNA vaccines, replication vector vaccines, inactivated vaccines and recombinant vaccines are safe to be administered in IBD patients, Ungaro said.

Additionally, the IOIBD said vaccines should not be deferred if an IBD patient is receiving immune-modifying therapies.

According to Ungaro, patients with IBD who take corticosteroids and get the vaccine should receive counseling that there may be a decreased systemic response. He said this needs to be studies further.

“There are prospective studies being planned to look at the real-world effectiveness and side effects of the COVID-19 vaccine in IBD patients,” Ungaro said. “This would require cohorts that are vaccinated and followed. There are studies that are ongoing for that both in the United States and internationally. [Surveillance Epidemiology of Coronavirus Under Research Exclusion-IBD (SECURE-IBD)] is going to help support some of these efforts as well.”

Ungaro and his team at Mount Sinai in collaboration with University of North Carolina developed the SECURE-IBD registry early in 2020 to monitor and report outcomes of COVID-19 in patients with IBD.

He said, “Physicians can encourage IBD patients to enroll in the Crohn’s and Colitis Foundation’s IBD Partners, they will be one of the sources for the prospective COVID-19 vaccine studies.”