Pfizer/BioNTech shots effective in IBD patients

The Pfizer-BNT162b2 vaccine for the coronavirus disease 2019 (COVID-19) effectively reduces the risk of serious outcomes and hospitalization in patients with inflammatory bowel diseases (IBD), though with slight variance in effectivity with respect to ongoing medications, reports a Qatar study presented at the recently concluded 2022 Crohn’s & Colitis Congress (CCC 2022).

“Our study is one of the first to report COVID-19 vaccine effectiveness in IBD patients in a real-world setting,” the researchers said. “Patients should continue to take precautionary measures until after the second vaccination dose. COVID-19 vaccination is safe in IBD patients and does not result in disease flare or serious adverse events.”

The study included 476 vaccinated IBD patients whose demographic, clinical, and treatment data were retrieved from electronic medical records. In particular, the use of biological agents and immunomodulators were recorded. Outcomes, such as any documented infection or symptomatic COVID-19, were compared against a parallel group of 476 matched unvaccinated IBD controls.

Over a total follow-up of 23,289 person-days for the vaccinated group and 23,653 for the unvaccinated group, the researchers documented a vaccine effectiveness of 85.1 percent >14 days after the second dose when considering all confirmed infections. When looking at symptomatic COVID-19 episodes, vaccine effectiveness rose slightly to 87.1 percent. [CCC 2022, Khan et al]

None of the patients were hospitalized 14 days after the second dose. There were also no reported cases of intensive care admission, death, IBD exacerbation, or vaccination-related adverse events requiring hospitalization.

Of note, the researchers reported that the vaccine afforded some degree of protection even before regimen completion. Between 22 and 35 days after the first dose, the estimated effectiveness was 14.8 percent for any documented COVID-19 infection and 59.8 percent for symptomatic disease.

Stratifying the analysis according to ongoing medications also showed high vaccine effectivity, with notable differences. Among patients taking biologics with or without concomitant immunomodulators, the Pfizer-BNT162b2 shot showed an estimated effectivity of 94 percent >14 days after the second dose for preventing any confirmed infection.

Meanwhile, the corresponding effectiveness for symptomatic COVID-19 over the same time window was 92.7 percent.

However, the jab appeared to be weaker in patients who were on immunomodulators alone, with estimated effectiveness of 87.4 percent and 91.7 percent for preventing any confirmed infection and symptomatic disease, respectively.

“We have shown that vaccination with Pfizer-BNT162b2 in IBD patients is effective, and that effectiveness is high for serious outcomes, including hospitalization and severe illness,” the researchers said.

“The vaccine effectiveness in IBD patients develops at 5–6 weeks, which is slightly delayed than what has been reported before, possibly secondary to delayed immunogenicity in these patients because of ongoing immunosuppressive treatment,” they added.