Effect of 2 vs 3 Doses of COVID-19 Vaccine in Patients With Inflammatory Bowel Disease: A Population-based Propensity Matched Analysis

Abstract

Aim There are limited data on the impact of 2 vs 3 doses of COVID-19 vaccine in patients with inflammatory bowel disease (IBD). The primary aim of the study was to assess the efficacy of COVID-19 vaccine based on number of administered doses in patients with IBD. Methods We conducted a retrospective cohort study using TriNetX, a multi-institutional database to compare patients with IBD who received 1, 2, or 3 doses of BNT162b2 or mRNA-1273 to unvaccinated IBD patients (1.1.2020-7.26.2022) to assess the risk of COVID-19 after 1:1 propensity score matching. We also evaluated the impact of vaccine on a composite of severe COVID-19 outcomes including hospitalization, intubation, intensive care unit care, acute kidney injury, or mortality. Results After propensity score matching, vaccinated patients with 2 (adjusted OR [aOR], 0.8; 95% confidence interval [CI], 0.6-0.9) and 3 doses (aOR, 0.7; 95% CI, 0.5-0.9) were found to have a lower risk of COVID-19 compared with unvaccinated patients. Vaccinated patients with IBD had a lower risk of severe COVID-19 outcomes (aOR, 0.7; 95% CI, 0.6-0.9) compared with unvaccinated patients. There was no difference in the risk of COVID-19 in IBD patients with 2 compared with 3 doses (aOR, 0.97; 95% CI, 0.7-1.3). However, IBD patients with 2 doses were at an increased risk for hospitalization due to COVID-19 (aOR, 1.78; 95% CI, 1.02-3.11) compared with those that received 3 doses. Conclusion Vaccinated patients with IBD had a lower risk of severe COVID-19 outcomes compared with unvaccinated patients. A third dose of COVID-19 vaccine compared with 2 doses decreases the risk of hospitalization but not breakthrough infection in patients with IBD.

Impact of the COVID-19 Pandemic on the Diagnostic Frequency and Medical Therapies Applied to Subjects With Functional Seizures

“…Data privacy, security, attestation, and steps taken to ensure de-identification have been previously described. 12,13…”

Impact of COVID-19 on Pediatric Inflammatory Bowel Diseases—From Expectations to Reality

“…However, vaccination was reported to be safe for both adults and children known to have IBD, with a low rate of vaccination-induced disease flare and a reduced risk of thrombotic events [23,[42][43][44]. Studies revealed that a third vaccine dose might be able to reduce COVID-19 incidence and lower the rates of severe outcomes, including hospital admission [45,46]. Schell and colleagues reported that IBD patients on biologics are susceptible to reinfection because of their weakened IgG response to natural SARS-CoV-2 infection [33].…”

COVID-19 aus Sicht der Gastroenterologie

“…Im klinischen Alltag ist insbesondere das aufklärende Gespräch bei großer Sorge der chronisch kranken Patienten vor der Infektion, aber auch vor Impfnebenwirkungen, wie sie u. a. für Patienten mit chronisch-entzündlichen Darmerkrankungen publiziert sind, eine Herausforderung [ 29 ]. Ein vollständiger Impfschutz reduziert auch bei immunmodulierend behandelten Patienten mit chronisch-entzündlichen Darmerkrankungen das Risiko einer COVID-19-Ansteckung und das Risiko von schwerer COVID-19-Verläufen [ 6 , 20 ]. Dabei wird in einer Metaanalyse aus 31 Studien mit 9447 Patienten eine Serokonversionsrate von 96 % nach vollständiger Impfung berichtet, wobei die Antikörpertiter bei Patienten unter alleiniger Tumornekrosefaktor(TNF)-α-Antikörper-Therapie oder in Kombination mit einem Immunmodulator rasch abfallen und im Verlauf kontrolliert werden sollten [ 19 ].…”