ABSTRACT
INTRODUCTION Patients with inflammatory bowel disease (IBD) may be more susceptible to certain infections including COVID-19. There are concerns regarding the safety and efficacy of the current available COVID-19 vaccines among IBD patients. The aim of this study is to perform a systematic review regarding the willingness of IBD patients to receive these types of vaccines, assess the reported adverse events and the efficacy of the vaccine among IBD patients. METHODS Medline, Embase, Scopus, Web of Science, and Cochrane databases were reviewed since inception till November 11th, 2021, by two independent reviewers. Relevant conference s were manually reviewed to identify additional studies. Studies that reported the willingness or rate of COVID vaccination, the adverse events, and/or efficacy of the COVID vaccine among IBD patients were included. Efficacy was defined as the ability of a vaccine to produce detectable antibodies. Meta-analysis was performed using a bivariate random-effects model. RESULTS 2049 studies were identified through database search and additional 10 conference s were extracted. 24 studies, with the majority (79%) from North America or Europe were included. Four studies reported the rate of adverse events of vaccines ranging from 39% to 74% after the first and second doses of vaccine, respectively. Pooled estimates of nine studies showed that only 59% of IBD patients (95% confidence interval (CI):39%-79%) were willing or had already received a vaccine. Pooled estimates of six studies showed the vaccine was 96% (95% CI: 92%-99%) effective in creating seroconversion in IBD patients. Three studies reported the incidence of break-through infection following COVID vaccination;The pooled estimates showed no statistically significant difference between the risk ratio of IBD patients versus healthy control (Risk difference:0.02 (95%CI: -0.02, 0.06), P-value:0.3). Mean values of antibody level were statistically significantly lower in IBD patients receiving immunosuppression compared with those who were not on immunosuppression (Standardized mean difference: -0.38 (95% CI: -0.58, -0.18), P-value:0.002). CONCLUSION COVID vaccines are protective against preventing COVID-19 infection in IBD patients. However, patients on immunosuppression may have reduced response and could benefit from a booster dose. More importantly, there should be more efforts in encouraging IBD patients towards vaccination. Additionally, is scarce data and further studies are required to assess the global effect of the COVID vaccine in IBD patients, particularly in underdeveloped countries. (Figure Presented)