Q&A: Expert recommends vaccination, booster for immunocompromised IBD patients
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Regardless of immunosuppression medication status, most patients with inflammatory bowel disease mounted a high-positive antibody response to the standard SARS-CoV-2 vaccination regimen, according to research.
“Immunosuppressive medications represent a mainstay of therapy in moderate to severe IBD; however, their impact on the SARS-CoV-2 vaccine response remains unclear,” Sarah Frey, a graduate student in the department of surgery at the Johns Hopkins School of Medicine, and colleagues wrote in Clinical Gastroenterology and Hepatology. “The aim of this study was to assess anti-spike antibody response 6 months after completion of standard SARS-CoV-2 vaccination in patients with IBD.”
At 6 months post-vaccination, Frey and colleagues measured antibody titers and detected a response in all 75 patients with IBD (78% women; median age, 45 years; 90.7% on immunosuppression medications). In addition, most patients (78.7%) mounted a high-positive antibody response.
In an exclusive Healio Q&A, Reezwana Chowdhury, MD, assistant professor of medicine in gastroenterology at the Johns Hopkins University School of Medicine, explained the importance of these results.
Healio: Why did your team conduct this investigation?
Chowdhury: It is recommended that IBD patients receive the SARS-CoV-2 vaccination regardless of their immunosuppression status. At the time of our study, the reported published data was about antibody responses in IBD patients 3 months after vaccination. Our aim was to assess spike antibody response 6 months after completion of vaccination.
Healio: What is the most important take-home message?
Chowdhury: The most important take home message from our article was that the majority of our patients had detectable antibodies at 6 months despite use of immunosuppression, which is encouraging for those patients.
Healio: How do these results inform management for this subset of patients going forward?
Chowdhury: This should assure or encourage our IBD or immunosuppressed patients that they can continue their immunosuppressive medications while receiving the vaccine and be able to mount an appropriate response.
Healio: What additional research, if any, is needed?
Chowdhury: We would like to assess response after booster doses of the COVID vaccine in the immunosuppressed population, as we did see a waning in antibody levels in a small subset of patients on anti-[tumor necrosis factor (TNF)].
We need larger studies to determine the significance of this finding and, thus, the current recommendation for boosters.
Healio: What advice would you give to clinicians treating this subgroup of patients?
Chowdhury: We recommend the vaccination and booster doses for our IBD patients — especially those who are immunocompromised. They should not hold off on receiving the vaccination or booster due to their immunosuppressive medications.
The majority of IBD patients respond appropriately to the mRNA vaccines; only one patient in our small subset reported a breakthrough infection after vaccination.
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