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COVID-19 Vaccine Is Effective in Inflammatory Bowel Disease Patients and Is Not Associated With Disease Exacerbation.
Lev-Tzion, Raffi; Focht, Gili; Lujan, Rona; Mendelovici, Adi; Friss, Chagit; Greenfeld, Shira; Kariv, Revital; Ben-Tov, Amir; Matz, Eran; Nevo, Daniel; Barak-Corren, Yuval; Dotan, Iris; Turner, Dan.
  • Lev-Tzion R; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel. Electronic address: raffilv@szmc.org.il.
  • Focht G; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University of Jerusalem, Jerusalem, Israel.
  • Lujan R; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel.
  • Mendelovici A; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel.
  • Friss C; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel.
  • Greenfeld S; Maccabi Health Services and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Kariv R; Maccabi Health Services and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Ben-Tov A; Maccabi Health Services and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
  • Matz E; Leumit Health Services, Tel-Aviv, Israel.
  • Nevo D; Department of Statistics and Operations Research, Tel Aviv University, Tel-Aviv, Israel.
  • Barak-Corren Y; Predictive Medicine Group, Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts.
  • Dotan I; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Turner D; Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University of Jerusalem, Jerusalem, Israel.
Clin Gastroenterol Hepatol ; 20(6): e1263-e1282, 2022 06.
Article in English | MEDLINE | ID: covidwho-1634596
ABSTRACT
BACKGROUND &

AIMS:

Studies have shown decreased response to coronavirus disease 2019 (COVID-19) vaccinations in some populations. In addition, it is possible that vaccine-triggered immune activation could trigger immune dysregulation and thus exacerbate inflammatory bowel diseases (IBD). In this population-based study we used the epi-Israeli IBD Research Nucleus validated cohort to explore the effectiveness of COVID-19 vaccination in IBD and to assess its effect on disease outcomes.

METHODS:

We included all IBD patients insured in 2 of the 4 Israeli health maintenance organizations, covering 35% of the population. Patients receiving 2 Pfizer-BioNTech BNT162b2 vaccine doses between December 2020 and June 2021 were individually matched to non-IBD controls. To assess IBD outcomes, we matched vaccinated to unvaccinated IBD patients, and response was analyzed per medical treatment.

RESULTS:

In total, 12,109 IBD patients received 2 vaccine doses, of whom 4946 were matched to non-IBD controls (mean age, 51 ± 16 years; median follow-up, 22 weeks; interquartile range, 4-24). Fifteen patients in each group (0.3%) developed COVID-19 after vaccination (odds ratio, 1; 95% confidence interval, 0.49-2.05; P = 1.0). Patients on tumor necrosis factor (TNF) inhibitors and/or corticosteroids did not have a higher incidence of infection. To explore IBD outcomes, 707 vaccinated IBD patients were compared with unvaccinated IBD patients by stringent matching (median follow-up, 14 weeks; interquartile range, 2.3-20.4). The risk of exacerbation was 29% in the vaccinated patients compared with 26% in unvaccinated patients (P = .3).

CONCLUSIONS:

COVID-19 vaccine effectiveness in IBD patients is comparable with that in non-IBD controls and is not influenced by treatment with TNF inhibitors or corticosteroids. The IBD exacerbation rate did not differ between vaccinated and unvaccinated patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / COVID-19 / BNT162 Vaccine Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Aged / Humans / Middle aged Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / COVID-19 / BNT162 Vaccine Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Aged / Humans / Middle aged Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2022 Document Type: Article