Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 1;29(2):268-273.
doi: 10.1093/ibd/izac187.

Humoral Immunogenicity After Vaccination Against SARS-CoV-2 Infection in Inflammatory Bowel Disease Patients Under Immunosuppressive Therapy: Should We Prioritize an Additional Booster Injection?

Vítor Macedo Silva  1   2   3 , Tiago Lima Capela  1   2   3 , Marta Freitas  1   2   3 , Tiago Cúrdia Gonçalves  1   2   3 , Pedro Boal Carvalho  1   2   3 , Francisca Dias de Castro  1   2   3 , Maria João Moreira  1   2   3 , José Cotter  1   2   3
Affiliations

Humoral Immunogenicity After Vaccination Against SARS-CoV-2 Infection in Inflammatory Bowel Disease Patients Under Immunosuppressive Therapy: Should We Prioritize an Additional Booster Injection?

Vítor Macedo Silva et al. Inflamm Bowel Dis. .

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to the development of the novel coronavirus disease (coronavirus disease 2019 [COVID-19]). Scarce data are available regarding safety and efficacy of SARS-CoV-2 vaccination in inflammatory bowel disease (IBD) patients, which may present differences between subgroups. Lower humoral immunological response could require additional booster injections.

Methods: This is a prospective study including adult patients with IBD after complete vaccination against SARS-CoV-2 infection with BioNTech vaccine. Patients with previous SARS-CoV-2 infection were excluded. A control group with healthy individuals matched for age and sex was also analyzed. Blood samples were collected 30 days after complete vaccination to quantify immunoglobulin G (IgG) antibody titers against SARS-CoV-2 in both groups.

Results: The final sample included 81 IBD and 32 non-IBD patients, 55 (48.7%) of them women, with a mean age of 40.2 ± 13.0 years. From IBD patients, 58 (71.6%) had Crohn's disease and 23 (28.4%) had ulcerative colitis. IBD patients had significantly lower median anti-SARS-CoV-2 IgG levels when compared with the control group (6479 [interquartile range (IQR) 1830-11883, 10 053] AU/mL vs 13 061 [IQR 2826-21427, 15 539] AU/mL; P = .003). Regarding IBD medication, significant lower levels of SARS-CoV-2 IgG antibodies when compared with control subjects were observed in patients treated with thiopurines (5423 [IQR 3109-13369, 10 260] AU/mL; P = .011), methotrexate (834 [IQR 507-3467, 4155] AU/mL; P = .002), anti-tumor necrosis factor α agents (5065 [IQR 1033-11669, 10 636] AU/mL; P = .001), and corticosteroids (548 AU/mL; P = .001). The incidence of SARS-CoV-2 infection after vaccination was also significantly higher in patients treated with these agents.

Conclusions: IBD patients treated with immunomodulators, anti-tumor necrosis factor α agents and corticosteroids presented significantly lower anti-SARS-CoV-2 IgG levels following complete vaccination when compared with healthy control subjects. These findings support the benefit of additional booster injections in this population.

Keywords: SARS-CoV-2; inflammatory bowel disease; vaccination.

Plain language summary

This is a prospective study quantifying antibody titers against severe acute respiratory syndrome coronavirus 2 after complete vaccination in adult patients with inflammatory bowel disease. Immunomodulators, infliximab, and corticosteroid treatment were associated with lower antibody levels. This could support the benefit of an additional booster injection in this population.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Comparison of immunoglobulin G (IgG) antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between the control group and patients treated with different inflammatory bowel disease medications. *P < .05; **P < .01. AU, arbitrary units; TNFα, tumor necrosis factor α.
See this image and copyright information in PMC

References

    1. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798):270-273. - PMC - PubMed
    1. Neurath MF. COVID-19 and immunomodulation in IBD. Gut 2020;69(7):1335-1342. - PMC - PubMed
    1. WHO Coronavirus (COVID-19) Dashboard. Accessed. January 3, 2022. https://covid19.who.int/
    1. Hodgson SH, Mansatta K, Mallett G, Harris V, Emary KRW, Pollard AJ. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. Lancet Infect Dis. 2021;21(2):e26-e35. - PMC - PubMed
    1. Selim R, Wellens J, Marlow L, Satsangi JJ. SARS-CoV-2 vaccination uptake by patients with inflammatory bowel disease on biological therapy. Lancet Gastroenterol Hepatol 2021;6(12):989. - PMC - PubMed