接种 SARS-CoV-2 mRNA 疫苗后炎症性肠病患者的疫苗接种后症状：一项前瞻性、对照研究。
Postvaccination Symptoms After SARS-CoV-2 mRNA Vaccination Among Patients With Inflammatory Bowel Disease: A Prospective, Comparative Study.
机构信息
Inflammatory Bowel and Immunobiology Research Institute, Karsh Division of Digestive and Liver Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Smidt Heart Institute, Department of Medicine, Cedars-Sinai, Los Angeles, CA, USA.
出版信息
Inflamm Bowel Dis. 2024 Apr 3;30(4):602-616. doi: 10.1093/ibd/izad114.
BACKGROUND
Vaccine hesitancy is prevalent among people with IBD, in part due to insufficient evidence regarding comparative safety of vaccines in this population.
METHODS
We conducted a nationwide comparative study of postvaccination symptoms among those with IBD and health care workers (HCWs) without IBD. Symptom frequency, severity, and duration were measured. Continuous and categorical data were analyzed using Wilcoxon rank-sum and Fisher's exact test. Regression analysis was used to adjust for confounding variables.
RESULTS
We had 2910 and 2746 subjects who completed a survey after dose 1 (D1) and dose 2 (D2) respectively (D1: HCW = 933, IBD = 1977; D2: HCW = 884, IBD = 1862). Mean age was 43 years, 67% were female, and 23% were nonwhite; 73% received BNT162b2 (Pfizer) including almost all HCWs and 60% of IBD patients. Most postvaccine symptoms were mild and lasted ≤2 days after both doses in both groups. Health care workers experienced more postvaccination symptoms overall than IBD patients after each dose (D1: 57% vs 35%, P < .001; D2: 73% vs 50%, P < .001). Gastrointestinal symptoms were noted in IBD more frequently after D1 (5.5% vs 3%, P = .003) but not after D2 (10% vs 13%, P = .07). Inflammatory bowel disease subjects who received mRNA-1273 (Moderna) reported more overall symptoms compared with BNT162b2 (57% vs 46%, P < .001) including gastrointestinal symptoms (12% vs 8%, P = .002) after D2.
CONCLUSIONS
People with IBD had fewer postvaccination symptoms following the first 2 doses of SARS-CoV-2 mRNA vaccines than HCWs. Among those with symptoms, most symptoms were mild and of short duration.
背景
疫苗犹豫在 IBD 患者中较为普遍，部分原因是关于此类人群中疫苗相对安全性的证据不足。
方法
我们对 IBD 患者和无 IBD 的医护人员（HCWs）进行了一项全国性的疫苗接种后症状比较研究。测量症状的频率、严重程度和持续时间。连续和分类数据分别采用 Wilcoxon 秩和检验和 Fisher 确切检验进行分析。回归分析用于调整混杂变量。
结果
我们分别有 2910 名和 2746 名患者在接种第 1 剂（D1）和第 2 剂（D2）后完成了调查（D1：HCW = 933，IBD = 1977；D2：HCW = 884，IBD = 1862）。平均年龄为 43 岁，67%为女性，23%为非白人；73%接受了 BNT162b2（辉瑞），包括几乎所有 HCWs 和 60%的 IBD 患者。在两组中，大多数疫苗接种后症状在两剂后均为轻度，持续时间≤2 天。每次接种后，HCWs 比 IBD 患者经历的疫苗接种后症状更多（D1：57%比 35%，P<0.001；D2：73%比 50%，P<0.001）。在 D1 后，IBD 患者更常出现胃肠道症状（5.5%比 3%，P=0.003），但在 D2 后没有（10%比 13%，P=0.07）。与 BNT162b2 相比，接受 mRNA-1273（Moderna）的 IBD 患者在接种第 2 剂后报告的总体症状更多（57%比 46%，P<0.001），包括胃肠道症状（12%比 8%，P=0.002）。
结论
与 HCWs 相比，IBD 患者在接种第 1 剂和第 2 剂 SARS-CoV-2 mRNA 疫苗后，疫苗接种后症状更少。在有症状的患者中，大多数症状较轻且持续时间短。
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