BACKGROUND & AIMS: Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly expanded; however, clinical trials excluded patients taking immunosuppressive medications such as those with inflammatory bowel disease (IBD). Therefore, we explored real-world effectiveness of coronavirus disease 2019 (COVID-19) vaccination on subsequent infection in patients with IBD with diverse exposure to immunosuppressive medications. METHODS: This was a retrospective cohort study of patients in the Veterans Health Administration with IBD diagnosed before December 18, 2020, the start date of the Veterans Health Administration patient vaccination program. IBD medication exposures included mesalamine, thiopurines, anti-tumor necrosis factor biologic agents, vedolizumab, ustekinumab, tofacitinib, methotrexate, and corticosteroid use. We used inverse probability weighting and Cox's regression with vaccination status as a time-updating exposure and computed vaccine effectiveness from incidence rates. RESULTS: The cohort comprised 14,697 patients, 7321 of whom received at least 1 vaccine dose (45.2% Pfizer, 54.8% Moderna). The cohort had median age 68 years, 92.2% were men, 80.4% were White, and 61.8% had ulcerative colitis. In follow-up data through April 20, 2021, unvaccinated individuals had the highest raw proportion of SARS-CoV-2 infection (197 [1.34%] vs 7 [0.11%] fully vaccinated). Full vaccination status, but not partial vaccination status, was associated with a 69% reduced hazard of infection relative to an unvaccinated status (hazard ratio, 0.31, 95% confidence interval, 0.17-0.56; P < .001), corresponding to an 80.4% effectiveness. CONCLUSIONS: Full vaccination (> 7 days after the second dose) against SARS-CoV-2 infection has an w80.4% effectiveness in a broad IBD cohort with diverse exposure to immunosuppressive medications. These results may serve to increase patient and provider willingness to pursue vaccination in these settings.

Grating-based X-ray phase-contrast imaging (XPCi) systems offer higher sensitivity compared to other XPCi methods; however, realizing a high-resolution, compact, dose-efficient imaging system has been a significant challenge from technological and practical points of view until now. X-ray gratings quality and characteristics directly determine the final imaging quality, where a proper grating fabrication process can potentially minimize image artifacts and increase the system visibility. To achieve a high-resolution, compact, dose-efficient XPCi system, high-resolution detectors and high-resolution X-ray absorption gratings are a must. Moreover, an efficient image processing method is required to retrieve multimodal XPCi information—transmission, refraction (phase-contrast), and dark-field—efficiently and simultaneously. In this work, we report on a compact XPCi system that enables multimodal information retrieval through single-shot imaging with two-directional sensitivity. We first present an elegant cost-effective fabrication method to make high-resolution micropillar-based X-ray absorption gratings. A prototype 2D grating is fabricated with micropillars with 4 μm in diameter, periodicity of 16.3 μm, and aspect ratio of more than 40. This grating is then employed along with a prototype hybrid a-Se/CMOS direct conversion high-resolution X-ray detector with a pixel pitch of 8 μm in a compact system with a polychromatic microfocus source to perform X-ray phase-contrast imaging of various samples. We successfully demonstrate a single-shot XPCi and retrieve multimodal XPCi data with transmission and dark-field metrics. The final system is a promising candidate for XPCi applications as it facilitates single-shot imaging, which reduces the exposure dose on samples and yields multimodal XPCi images efficiently, all in a compact bench-top setup. The delivered X-ray dose at the sample, resolution of the system, and compactness of the reported imaging setup are potentially beneficial for ex vivo, in vivo, and computed tomography (CT) imaging applications.