COVID vaccine spurs good response in people with Crohn's disease and colitis
Here's some comforting news for people who struggle with inflammatory bowel disease and worry that the immune-suppressing drugs they must take might blunt their response to COVID-19 vaccines: New research finds vaccination triggers a strong immune reaction in these patients.
"At eight weeks, following completion of a two-dose mRNA vaccine series, 99% of patients had detectable antibodies from the vaccine, irrespective of whether or not they were receiving immunocompromising therapies," said lead study author Dr. Gil Melmed. He is director of inflammatory bowel disease clinical research at Cedars-Sinai in Los Angeles.
Previous research has shown that other groups of patients receiving treatments that weaken their immune systems—such as transplant patients who take drugs to prevent organ rejection and cancer patients receiving chemotherapy—display much lower rates of antibody response to COVID-19 vaccines.
The new study was published recently in the Annals of Internal Medicine.
Ulcerative colitis and Crohn's disease are two forms of inflammatory bowel disease (IBD), in which an abnormal immune response causes chronic and often destructive inflammation of the digestive tract. Many patients with IBD take medications to suppress their immune system.
The study did find that the antibody response in IBD patients differed at a certain point after receiving their second dose of COVID-19 vaccine, and the differences were due to the type of immunosuppressive medications they were taking.
According to co-principal investigator Dr. Dermot McGovern, "After eight weeks, we noted lower antibody levels in patients receiving anti-TNF (tumor necrosis factor) therapies or corticosteroids compared to patients treated with the immune-response blocking drugs anti-tegrin, anti-IL12/23." McGovern is director of translational research at the Inflammatory Bowel and Immunobiology Research Institute at Cedars-Sinai.
"However," he added, "these findings should still reassure IBD patients—and the millions of people who use these types of immunosuppressive medications—that the immediate response to mRNA vaccines against SARS-CoV-2, the virus that causes COVID-19, is good and on par with IBD patients who are not taking any drug therapies. Even so, patients receiving anti-TNF therapy or corticosteroids may be the ones most likely to benefit from a third dose of the vaccine."
Overall, the IBD patients' antibody response to COVID-19 vaccination was similar to that of people with healthy immune systems, the researchers noted.
Immunosuppressed patients are often viewed as a high-risk group. But, Melmed said, this "study shows that while there may be differences based on medication types, almost all IBD patients have positive responses to the mRNA vaccine."
The researchers are now assessing other aspects of COVID-19 vaccine response in IBD patients more directly associated with protection from infection, such as T-cell function and neutralizing antibody responses.
Gil Y. Melmed et al, Antibody Responses After SARS-CoV-2 mRNA Vaccination in Adults With Inflammatory Bowel Disease, Annals of Internal Medicine (2021). DOI: 10.7326/M21-2483
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