Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK; Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK.
NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals and The University of Nottingham, Nottingham, UK.
Lancet Gastroenterol Hepatol. 2021 Mar;6(3):218-224. doi: 10.1016/S2468-1253(21)00024-8. Epub 2021 Jan 26.
SARS-CoV-2 has caused a global health crisis and mass vaccination programmes provide the best opportunity for controlling transmission and protecting populations. Despite the impressive clinical trial results of the BNT162b2 (Pfizer/BioNTech), ChAdOx1 nCoV-19 (Oxford/AstraZeneca), and mRNA-1273 (Moderna) vaccines, important unanswered questions remain, especially in patients with pre-existing conditions. In this position statement endorsed by the British Society of Gastroenterology Inflammatory Bowel Disease (IBD) section and IBD Clinical Research Group, we consider SARS-CoV-2 vaccination strategy in patients with IBD. The risks of SARS-CoV-2 vaccination are anticipated to be very low, and we strongly support SARS-CoV-2 vaccination in patients with IBD. Based on data from previous studies with other vaccines, there are conceptual concerns that protective immune responses to SARS-CoV-2 vaccination may be diminished in some patients with IBD, such as those taking anti-TNF drugs. However, the benefits of vaccination, even in patients treated with anti-TNF drugs, are likely to outweigh these theoretical concerns. Key areas for further research are discussed, including vaccine hesitancy and its effect in the IBD community, the effect of immunosuppression on vaccine efficacy, and the search for predictive biomarkers of vaccine success.
SARS-CoV-2 引发了全球健康危机,大规模疫苗接种计划为控制传播和保护人群提供了最佳机会。尽管 BNT162b2(辉瑞/生物科技)、ChAdOx1 nCoV-19(牛津/阿斯利康)和 mRNA-1273(莫德纳)疫苗的临床试验结果令人印象深刻,但仍存在一些重要的未解决问题,特别是在患有基础疾病的患者中。在英国胃肠病学会炎症性肠病(IBD)分会和 IBD 临床研究小组认可的这份立场声明中,我们考虑了 IBD 患者的 SARS-CoV-2 疫苗接种策略。预计 SARS-CoV-2 疫苗接种的风险非常低,我们强烈支持 IBD 患者接种 SARS-CoV-2 疫苗。基于其他疫苗的先前研究数据,人们对一些 IBD 患者(如接受抗 TNF 药物治疗的患者)对 SARS-CoV-2 疫苗的保护性免疫反应可能减弱存在概念上的担忧。然而,接种疫苗的益处,即使是在接受抗 TNF 药物治疗的患者中,也很可能超过这些理论上的担忧。我们讨论了进一步研究的重点领域,包括疫苗犹豫及其对 IBD 社区的影响、免疫抑制对疫苗效果的影响,以及寻找疫苗成功的预测性生物标志物。