Translational Gastro-Intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK.
Translational Research for Gastrointestinal Diseases, University Hospitals Leuven, Leuven, Belgium.
J Crohns Colitis. 2021 Aug 2;15(8):1376-1386. doi: 10.1093/ecco-jcc/jjab046.
Since the beginning of the pandemic, patients with inflammatory bowel diseases [IBD] have been considered at high risk for infection and complications of COVID-19. IBD patients and patients taking immunosuppressive therapy were excluded from clinical phase III vaccine trials, complicating the assessment of effectiveness of these new vaccines. From past experience we know that adapted vaccination strategies may be appropriate in some IBD patients to optimise immunogenicity. We review current evidence on SARS-CoV-2 vaccination relevant to IBD patients, including immune responses from humoral to cellular, emerging data on new variants, and off-label vaccination schemes. We also identify clinical and scientific knowledge gaps that can be translated into both large-scale population-based studies and targeted vaccine studies to describe the precise immune responses induced by SARS-CoV-2 vaccines in IBD patients. We strongly endorse the recommendation of vaccinating IBD patients to ensure maximal protection from COVID-19 both for the individual and the community.
自疫情开始以来，炎症性肠病（IBD）患者被认为感染 COVID-19 及出现并发症的风险较高。IBD 患者和接受免疫抑制治疗的患者被排除在临床三期疫苗试验之外，这使得评估这些新型疫苗的有效性变得复杂。根据以往经验，我们知道在某些 IBD 患者中，适应性疫苗接种策略可能有助于提高免疫原性。我们综述了与 IBD 患者相关的 SARS-CoV-2 疫苗接种的现有证据，包括体液免疫到细胞免疫的反应、新型变异的出现数据以及标签外疫苗接种方案。我们还确定了临床和科学知识空白，这些空白可以转化为基于人群的大规模研究和针对疫苗的研究，以描述 SARS-CoV-2 疫苗在 IBD 患者中诱导的确切免疫反应。我们强烈支持为 IBD 患者接种疫苗的建议，以确保个体和社区都能最大程度地预防 COVID-19。
