PHILADELPHIA — Even after years of the COVID-19 pandemic, data remains somewhat limited on the safety profile of SARS-CoV-2 vaccine in patients taking immunosuppressive medications. A recent study focused on adverse events after vaccination of a nationwide cohort of inflammatory bowel disease (IBD) patients on diverse immunosuppressive medications.
The retrospective cohort study, led by researchers from the Corporal Michael J Crescenz VAMC in Philadelphia, used VHA data. Defined as the primary outcome was any adverse event of special interest, (cerebrovascular accident, venous thromboembolism, acute myocardial infarction, Bell’s palsy) within 90 days of vaccination.
The results were published in Clinical and Translational Gastroenterology and were related to 17,201 patients, of whom 71.8% had received at least one vaccine dose. Researchers reported that the most common adverse events were acute myocardial infarction and venous thromboembolism. “In inverse probability treatment weighting-adjusted logistic regression, full vaccination was not significantly associated with increased adverse events through 90 days, relative to unvaccinated patients,” they advised.2
The study was important, because vaccine hesitancy is high in IBD patients, according to another recent study, which involved researchers from the VA Maryland Healthcare System.
In the research published in Frontiers in Medicine, the study team sought to examine the reasons for vaccine hesitancy in patients with IBD. To do that, researchers performed a retrospective chart review of 1.3 million IBD patients and 215 non-IBD patients seen at University of Maryland Medical Center, a tertiary referral medical center, between March 2020 and October 2021.2
Data obtained included demographics, vaccination records, disease history, number of IBD-related surgeries and IBD medications. In that study, 813 of 1,349 (60.3%) IBD patients received at least one dose of either the Pfizer/BioNTech, Moderna or Johnson & Johnson vaccines.
Results indicated that COVID vaccination was found to be positively associated with:
- older age (p-value = 1.65e-5),
- female sex (p = 0.00194),
- Asian and white races (p = 0.02330, 0.00169),
- number of clinic visits (p = 1.11e-08), and
- biologic use (p = 7.82e-5).
“There was no association between vaccination and other types of vaccination nor with the use of other IBD medications,” the authors pointed out. “There was a negative association between vaccination status and the total number of IBD related surgeries (p = 0.02857).”
They added that, in non-IBD patients, only the number of clinic visits was positively associated with COVID-19 vaccination. “Although the majority of IBD patients are immunosuppressed, COVID-19 vaccination rate was only 60.3%,” the researchers advised. “Younger adults, males, African Americans, and those requiring IBD-related surgeries were less likely to receive COVID-19 vaccine. Healthcare providers need to recognize these potential risk factors for COVID-19 vaccine hesitancy.”
- Mahmud N, Reinisch W, Patel M, Sundararajan R, Khan N. ADVERSE EVENTS RELATED TO SARS-COV-2 VACCINE IN A NATIONWIDE COHORT OF INFLAMMATORY BOWEL DISEASE PATIENTS. Clin Transl Gastroenterol. 2022 Dec 6. doi: 10.14309/ctg.0000000000000554. Epub ahead of print. PMID: 36508224
- Kwon HJ, Panagos K, Alizadeh M, Bell M, Bourmaf M, Zisman E, Paul P, Sibel L, Wong U. Patients with inflammatory bowel disease are more hesitant about Coronavirus disease 2019 vaccination. Front Med (Lausanne). 2022 Nov 15;9:1005121. doi: 10.3389/fmed.2022.1005121. PMID: 36457565; PMCID: PMC9707735.
