Background and AimsPatients with inflammatory bowel disease (IBD) and underrepresented minorities (URMs) historically have below average vaccination rates. URMs have increased morbidity and mortality from COVID-19. We surveyed IBD patients to assess COVID vaccination attitudes, particularly among URMs. Methods In May and June 2021, all 822 adult patients with IBD, medically homed at a tertiary IBD referral center and safety net hospital, and with access to the electronic patient portal, were sent an electronic survey assessing their attitudes regarding COVID-19 vaccination. An additional 115 without access to the patient portal were contacted by phone. Demographic and clinical data were recorded. The primary outcome was vaccination hesitancy, defined as: likely will become vaccinated later this year, but not immediately; unsure if they will get the vaccine; or do not want the vaccine. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) of factors associated with vaccination intent. ResultsThe mean age was 46.6 years (SD 15.1). 210/1029 patients responded to the survey: 150/822 (18.2%) electronically and 60/115 (52.2%) by phone. Overall vaccine hesitancy rate was 11.9%, significantly higher in younger (aOR for 10-year increments, 0.64; 95% confidence interval [CI], 0.46-0.90, p = 0.011), Hispanic (aOR, 7.67; 95% CI, 2.99-21.3, p < 0.0002), and Black patients (aOR, 3.52; 95% CI 1.11-11.1, p = 0.050). Safety concerns were the most cited reasons for vaccine hesitancy. Conclusions URM patients were more vaccine hesitant. Future studies should further explore factors leading to lower vaccination rates among these groups and strategies to improve COVID-19 vaccination rates.

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Background Genome‐wide association studies (GWAS) have identified approximately 40 risk loci associated with Alzheimer’s disease (AD). However, only a fraction of heritability has been explained. In large meta‐analysis, smoking was associated with AD dementia. In this study, we sought to identify interactions between smoking and single‐nucleotide polymorphisms (SNPs) to further characterize AD genetic architecture. Method We used a subset of datasets of individuals of European ancestry from the Alzheimer’s Disease Genetic Consortium (ADGC) that had smoking information available from parent studies. The presence of any past or current smoking habit was considered to be positive smoking exposure. In each dataset, we ran a genome‐wide case‐control analysis including SNP and smoking main terms, and a SNP‐smoking interaction term. Models were adjusted for age, sex, and principal components of population substructure. Results from each dataset were meta‐analyzed using the inverse variance method. Pathway analysis of top SNPs was run using Ingenuity. Result The sample included 6,916 total individuals, including 2,862 AD cases and 4,054 controls. Although no interaction terms reached genome‐wide significance, there were two suggestive loci: top SNP rs3734416 [minor (C) allele frequency (MAF) = 0.27; interaction P = 7.2 × 10−6; OR for C allele in smokers = 1.23; OR for C allele in non‐smokers = 0.86] on chromosome 6 within the gene MTHFD1L and 95kb downstream of PLEKHG1, and top SNP rs693951 [MAF (G) = 0.27; interaction P = 1.3 × 10−6; OR for major A allele in smokers = 1.31; OR for A allele in non‐smokers = 0.83] on chromosome 8, 70kb upstream of ANGPT1. Pathway analysis implicated cellular development, cellular growth and proliferation and nervous system development and function. MTHFD1L has been implicated in candidate gene studies of AD and PLEKHG1 has been implicated in a GWAS of white matter hyperintensities. ANGPT1 has been implicated in recovery after ischemic stroke in candidate gene, transcriptomic and blood‐based biomarker studies. Conclusion We found suggestive evidence of a smoking‐SNP interaction associated with AD risk at 2 loci previously linked with AD and cerebrovascular disease, but that were not identified in the largest AD GWAS to date. Expansion of the sample and replication are underway.

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