Experts Weigh-In on the COVID-19 Vaccine for IBD Patients
STEVEN SANDBERG-LEWIS
N.D., DHANP
The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) is a global organization comprised of physicians and researchers focused on studying treatments for IBD (Crohn’s and ulcerative colitis). The IOIBD includes 92 such scientists from 27 countries. A portion of this group recently met over zoom to discuss and recommend the best use of covid-19 (SARS-CoV-2) vaccines in IBD patients. In attendance were 34 adult gastroenterologists, 2 pediatric gastroenterologists, 2 GI surgeons and 1 pathologist. Participants included 18 from North America, 2 from South America, 13 from Europe, 3 from Israel, 3 from Asia and 1 from New Zealand.
Here are their findings and recommendations (1) (these had 90% agreement or above):
Currently available COVID vaccinations do not cause IBD or induce flares.
Whether or not they are taking immune suppressive treatments, IBD patients can receive all non-live vaccines (such as the current available COVID vaccines).
If live virus vaccines (or those that are able to replicate) become available, these should not be used in IBD patients.
IBD patients can mount the desired immune response to these vaccines although the immunosuppressive treatments may partially reduce the response.
Those receiving Remicade (Infliximab) infusions can get the vaccines on the day of the infusion or any other time in the cycle without reducing efficacy.
IBD patients should receive the same vaccine dosing regimen as those who do not have IBD.
Taking corticosteroids, thiopurines, methotrexate, immunomodulator and/or anti-TNF treatment is associated with less than optimal vaccine responses. Patients with IBD on infliximab or adalimumab have decreased antibody titers compared with a control group in response to the inactivated influenza virus.
Based on local recommendations, if the vaccine was considered safe for pregnant women, it was safe for IBD patients during pregnancy as well.
Another article on this topic reminds us that these recommendations may change as new variants emerge. (2)
Citations:
Siegel CA et al, SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting. Gut. 2021 Apr; 70(4): 635–640. PMID: 33472895
Segal JP et al, The impact of SARS-CoV-2 variants on IBD management. Lancet Gastroenterol Hepatol. 2021 May; 6(5): 343–344. PMID: 33711289
Steven Sandberg-Lewis, ND has been in clinical practice for 43 years with a practice focused on functional gastroenterology At Hive Mind Medicine. He is a professor at the National University of Natural Medicine, a co-founder of Hive Mind Medicine, a prolific lecturer featured in professional seminars, webinars, interviews and podcasts and the author of the textbook Functional Gastroenterology (2nd edition, 2017) and the Townsend Letter column entitled Functional Gastroenterology Bolus.
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