Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin.
WMJ. 2023 Dec;122(5):450-455.
Patients with inflammatory bowel disease on systemic corticosteroids may be at higher risk of adverse outcomes of COVID-19 infection, and vaccination is an essential preventive measure. Uptake of the original 2-dose COVID-19 messenger RNA (mRNA) primary vaccine series was previously high among patients with inflammatory bowel disease, while uptake of subsequent doses based on interval recommendations made by the Advisory Committee on Immunization Practice remains unknown. Herein, we evaluated uptake of 3 COVID-19 mRNA vaccine doses among patients with inflammatory bowel disease.
A total of 1012 patients were identified; 728 (71.9%) patients received 3 COVID-19 vaccine doses. Multivariable logistic regression revealed that younger age (odds ratio [OR] 1.02; 95% CI, 1.01 - 1.03; P = 0.001), rural status (OR 3.44; 95% CI, 2.17 - 5.56; < 0.001), underrepresented minority status (OR 3.85; 95% CI, 1.89 - 7.69; < 0.001), and absence of influenza vaccination (OR 8.17; 95% CI, 5.41 - 12.33; < 0.001) were significantly associated with incomplete COVID-19 vaccination.
Of 1362 patients, 83.3% completed a COVID-19 vaccination series. Younger patients had increased odds of not completing a COVID-19 vaccination series (mean [SD] 46.7 [14.7] vs 54.3 [15.8]; OR 1.03; 95% CI, 1.02-1.04; < 0.001). Those who identified as non-White (1.88; 95% CI, 1.16-3.04; P = 0.010) or current smoker (1.85, 95% CI, 1.85-2.79; P = 0.004) had increased odds of not completing a COVID-19 vaccination series. Those who resided in rural ZIP codes (1.81; 95% CI, 1.35-2.43; < 0.001), had not received a 2019-2020 influenza vaccine (5.13; 95% CI, 3.79-6.96; < 0.001), or had lower comorbidity scores (2.95; 95% CI, 1.98-4.41; < 0.001) had higher odds of not completing a COVID-19 vaccination series.
Receipt of 3 COVID-19 mRNA vaccine doses is high overall among patients with inflammatory bowel disease. Younger age, underrepresented race/ethnicity, rural status, and lack of influenza vaccination are associated with incomplete COVID-19 vaccination.
正在接受全身性皮质类固醇治疗的炎症性肠病患者可能面临更高的 COVID-19 感染不良结局风险，接种疫苗是预防的重要手段。在炎症性肠病患者中，最初的两剂 COVID-19 信使 RNA（mRNA）初级疫苗系列的接种率很高，而根据免疫实践咨询委员会的间隔建议接种后续剂量的情况尚不清楚。在此，我们评估了炎症性肠病患者接种 3 剂 COVID-19 mRNA 疫苗的情况。
共确定了 1012 名患者；728 名（71.9%）患者接受了 3 剂 COVID-19 疫苗。多变量逻辑回归显示，年龄较小（比值比 [OR] 1.02；95%CI，1.01-1.03；P=0.001）、农村状态（OR 3.44；95%CI，2.17-5.56；<0.001）、代表性不足的少数族裔状态（OR 3.85；95%CI，1.89-7.69；<0.001）和未接种流感疫苗（OR 8.17；95%CI，5.41-12.33；<0.001）与 COVID-19 疫苗接种不完全显著相关。
在 1362 名患者中，83.3% 完成了 COVID-19 疫苗接种系列。年轻患者完成 COVID-19 疫苗接种系列的可能性较低（平均[SD]46.7[14.7]比 54.3[15.8]；OR 1.03；95%CI，1.02-1.04；<0.001）。那些自我认定为非白人（1.88；95%CI，1.16-3.04；P=0.010）或当前吸烟者（1.85，95%CI，1.85-2.79；P=0.004）的患者完成 COVID-19 疫苗接种系列的可能性增加。那些居住在农村邮政编码地区（1.81；95%CI，1.35-2.43；<0.001）、未接种 2019-2020 年流感疫苗（5.13；95%CI，3.79-6.96；<0.001）或合并症评分较低（2.95；95%CI，1.98-4.41；<0.001）的患者完成 COVID-19 疫苗接种系列的可能性更高。
总体而言，炎症性肠病患者接受 3 剂 COVID-19 mRNA 疫苗接种的比例很高。年龄较小、代表性不足的种族/族裔、农村地区和缺乏流感疫苗接种与 COVID-19 疫苗接种不完全有关。
