Weaver Kimberly N, Kappelman Michael D, Long Millie D
Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Pediatrics, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Gastroenterol Hepatol (N Y). 2022 Jul;18(7):388-399.
The COVID-19 pandemic, caused by SARSCoV-2, has been the most significant global health crisis of the past century. The development of safe and effective vaccines has led to a reduction in COVID19-related hospitalizations and deaths; however, the clinical trials that led to US Food and Drug Administration Emergency Use Authorization and/or approval of the vaccines in the United States did not include individuals with inflammatory bowel disease (IBD). Because individuals with IBD are commonly treated with immunosuppressive medications, there had been concern for reduced vaccine efficacy in this population. This article provides an overview of the peer-reviewed literature addressing COVID-19 vaccination in individuals with IBD; details the perceptions of patients with IBD of COVID-19 vaccines, including how gastroenterologists can help to reduce vaccine hesitancy; and describes the humoral immune response to COVID-19 vaccines, with a majority of patients with IBD seroconverting following complete vaccination regardless of medication exposure. Additionally, low rates of IBD flare and similar rates of vaccine-related adverse events to those in the general population are described. Finally, the article provides current recommendations from the Centers for Disease Control and Prevention for COVID-19 vaccination in individuals with IBD.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的2019冠状病毒病疫情,是过去一个世纪以来最重大的全球健康危机。安全有效的疫苗的研发已使与2019冠状病毒病相关的住院率和死亡率有所降低;然而,导致美国食品药品监督管理局(US Food and Drug Administration)对这些疫苗给予紧急使用授权和/或批准的临床试验并未将炎症性肠病(IBD)患者纳入其中。由于IBD患者通常会接受免疫抑制药物治疗,因此人们曾担心该人群中疫苗效力会降低。本文概述了针对IBD患者接种2019冠状病毒病疫苗的同行评议文献;详细介绍了IBD患者对2019冠状病毒病疫苗的看法,包括胃肠病学家如何帮助减少疫苗犹豫现象;并描述了对2019冠状病毒病疫苗的体液免疫反应,大多数IBD患者在完成疫苗接种后会发生血清转化,无论其是否接触过相关药物。此外,还介绍了IBD病情复发率较低以及疫苗相关不良事件发生率与普通人群相似的情况。最后,本文提供了美国疾病控制与预防中心(Centers for Disease Control and Prevention)目前针对IBD患者接种2019冠状病毒病疫苗的建议。