The Inflammatory Bowel Disease section of the British Society of Gastroenterology (BSG) and the Inflammatory Bowel Disease Clinical Research Group have published a position statement on SARS-CoV-2 vaccination for patients with inflammatory bowel disease (IBD).
For all three COVID-19 vaccines currently available, immunosuppression is not a contraindication. It is not yet possible to determine if vaccination will have an effect on IBD disease severity.
Key messages
The key messages from the statement are:
- SARS-CoV-2 vaccination for patients with IBD is strongly supported.
- The risks of SARS-CoV-2 vaccination in patients with IBD are anticipated to be very low.
- Key concerns relate to the theoretical risk of suboptimal vaccine responses, which has been documented with other vaccines.
- Patients with IBD should accept whichever approved SARS-CoV-2 vaccination is offered to them.
- Patients should be offered consistent and unbiased advice. This will be disseminated through the BSG and Crohn’s & Colitis UK.
In keeping with the BSG risk grid, categorisation of IBD patients are:
- Residents in a care home for older adults and their carers.
- People ≥80 years of age and front-line health and social care workers.
- People ≥75 years.
- People ≥70 years and clinically extremely vulnerable individuals.
- All those 65 years of age and over.
- People aged 16-64 years with underlying health conditions.
- People 60 years of age and over.
- All those 55 years of age and over.
- All those 50 years of age and over.
- For most patients, active IBD should not be a barrier to vaccination.
- Patients with severe IBD flares or those requiring hospitalisation, may prefer a short delay pending recovery.
- Maintenance immunosuppression should not be withheld for vaccination.
- The timing of subcutaneous or intravenous IBD medications should not delay vaccination.
- Co-administration of the influenza vaccine and SARS-CoV-2 vaccine at the same visit is not advised.
- Other vaccines such as influenza and pneumococcal vaccines should be scheduled at intervals of at least seven days from SARS-CoV-2 vaccination.
- Whether different immunosuppressive regimens impair the development of antiSARS-CoV-2 immunity.
- Precision vaccination, i.e., baseline features which predict how individual patients will respond to vaccination and to what extent, e.g., germline genetics, host transcriptional responses, microbiome, metabolome and particular immune features.
- Qualitative research on attitudes towards SARS-CoV-2 vaccination in patients with IBD.
References
References
