COVID-19 vaccines well-tolerated in pregnant people with inflammatory bowel disease
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Patients with inflammatory bowel disease tolerated COVID-19 vaccines well regardless of pregnancy status, according to a poster presented at the Infectious Diseases Society for Obstetrics and Gynecology Annual Meeting.
“In general, pregnant and lactating people tolerate the COVID-19 vaccine really well, so that is not surprising,” Alisa B. Kachikis, MD, MSc, an OB/GYN and attending in the division of maternal-fetal medicine at the University of Washington in Seattle, told Healio. “There is always concern with how individuals who have autoimmune or inflammatory conditions will respond to vaccines, and it is reassuring to find that people with [inflammatory bowel disease (IBD)] did well with COVID-19 vaccines.”
Kachikis and colleagues surveyed participants of an ongoing online prospective cohort study who had ulcerative colitis (n = 107), Crohn’s disease (n = 96) or unspecified IBD (n = 117) and who were pregnant, lactating and/or planning a pregnancy when they received their COVID-19 vaccine. In the surveys, participants self-reported their local and systemic vaccine reactions and changes in perceived disease status.
The researchers determined disease status using scores on the Simple Clinical Colitis Activity Index (SCCAI) for participants with ulcerative colitis and scores on the Harvey-Bradshaw Index (HBI) for those with Crohn’s disease.
Among all participants, 146 (46%) received their first dose during pregnancy, 139 (43%) received their second dose during pregnancy and 28 (9%) received their third dose during pregnancy. Most participants received the Pfizer-BioNTech vaccine.
At least one systemic vaccine reaction occurred in 50%, 81% and 66% of patients following the first, second and third doses, respectively, with the highest number of reactions occurring with the second dose across IBD subgroups. However, there were no statistically significant differences in the occurrence of systemic and local reactions between IBD subgroups. Kachikis emphasized that these reactions — when they occur — are usually temporary and are “outweighed by the benefit of receiving COVID-19 vaccines and having better immune protection against COVID-19 illness.”
Of note, less than 3% of participants experienced an IBD flare-up after COVID-19 vaccination, 25% of whom were pregnant when they were vaccinated. This suggests that pregnant people may have fewer IBD flares after vaccination, according to the researchers.
Mean SCCAI and HBI scores were 1.4 (standard deviation, ± 1.8) and 2.1 (standard deviation, ± 2.4), indicating a large proportion of participants achieved or sustained clinical remission after vaccination.
“There are still a lot of unanswered questions about IBD and pregnancy, and about pregnancy in general,” Kachikis said. “I would love to know more about immunity of people with IBD who are pregnant or lactating and responses to the COVID-19 vaccine.”