Views of patients with inflammatory bowel disease on the safety of biologics and vaccination during the covid-19 pandemic

ABSTRACT

Introduction: The American Gastroenterological Association (AGA) guidelines recommend continuing the use of biologics in those who have not tested positive for COVID-19 and are asymptomatic. 1 This study evaluated the views of patients with IBD on biologics and COVID-19 vaccination during the COVID-19 pandemic. Methods: We surveyed 204 participants through Amazon Mechanical Turk that fulfilled the inclusion criteria of >18 years old, diagnosed with IBD, and on a biologic. The study was approved by the institutional review board. A five-point Likert scale was used to gauge participants' level of understanding of the risks and benefits of biologics during the pandemic. Participants were also asked what they would do with their biologic if tested positive for COVID-19 and their willingness to accept the COVID-19 vaccine. Descriptive statistics were used to analyze data. Results: Majority of the participants were male (60.1%), under the age of 50 (95.1%), had at least a high school degree/GED (99%), and were insured (90.6%). Participants reported moderate understanding (mean±SD, 2.8±1.1) of the risks and benefits of biologic use for IBD during the COVID-19 pandemic. A remarkable number of participants, 43.6%, reported stopping their biologic due to fear of contracting COVID-19. Also, the majority of participants would “somewhat” agree to be vaccinated against COVID-19 vaccine if the vaccine is available to them (mean±SD, 2.0±1.1) and their attitude toward the vaccination did not change even if their gastroenterologists were to recommend the vaccine (Table 1). Conclusion: Despite recommendations from the AGA to continue one's biologic, a significant number of participants reported either decreasing their dose or stopping their biologic. The participants also reported only a “moderate understanding” of the risks and benefits of using biologics during the pandemic. Most striking, participants' attitude towards receiving a COVID-19 vaccine did not change even if a gastroenterologist were to recommend it. Thus, there is a need to evaluate each patient's biologic compliance and educate patients on the impact of COVID-19 on their treatment plan at their gastroenterology appointments. Further inquiry at appointments is also needed to understand vaccination hesitancy.