SARS-CoV-2-inactivated vaccine hesitancy and the safety in inflammatory bowel disease patients: a single-center study

Abstract

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine is thought to be the most effective preventive method of controlling the coronavirus disease 2019 (COVID-19) epidemic. Some patients with immune-related diseases, including inflammatory bowel disease (IBD) patients, however, may hesitate to be vaccinated for various reasons. Although several guidelines recommend vaccinating all IBD patients with inactivated SARS-CoV-2 vaccines, there is still a lack of real-world data on the safety of inactivated SARS-CoV-2 vaccines and COVID-19 vaccination rate in IBD patients. In this study, we investigated the reasons for hesitancy in COVID-19 vaccination, the COVID-19 vaccination rate, and the safety of SARS-CoV-2-inactivated vaccination in patients with IBD. Methods: This was a retrospective study. A total of 418 participants with IBD were enrolled to calculate the vaccination rates. A total of 232 patients with IBD who did not receive SARS-CoV-2 vaccination were recruited to investigate the reasons for hesitation. A follow-up survey of 151 IBD patients and 188 healthy participants who had received the SARS-CoV-2-inactivated vaccination was conducted to analyze adverse reactions. Results: The COVID-19 vaccination rate was 49.3% and almost half of the participants were ‘Concerned about the safety of the vaccine (such as adverse reactions) due to IBD’. After SARS-CoV-2 vaccination, adverse reactions were mild or moderate. The adverse reactions in the IBD and non-IBD populations were roughly the same, and IBD medications did not increase the risk of adverse reactions. Conclusion: SARS-CoV-2-inactivated vaccination rates in IBD patients are still low and a significant proportion of patients are hesitant about the vaccine because of safety concerns. SARS-CoV-2-inactivated vaccination in patients with IBD appears to be safe.

COVID-19 Immunization Rates in Patients with Inflammatory Bowel Disease Worldwide: A Systematic Review and Meta-Analysis

“…Regarding gender, greater levels of compliance were noted among females [26,28,35], and various studies [25][26][27][28][30][31][32]35] indicated reduced hesitancy among older individuals. Social determinants have also emerged as significant factors.…”

“…Furthermore, two studies were excluded due to the unavailability of the full text. As a result, 13 studies were considered eligible and met the inclusion criteria [24][25][26][27][28][29][30][31][32][33][34][35][36] (Table 1), while 111 studies were excluded for not meeting the specified criteria. Two studies were from the US, two from China, two from the UK, two from Italy, one from Poland, one from Denmark, one from Canada, one from Australia, and one from Kuwait (Table 1, Figure 2).…”

“…These sensitivity analyses did not indicate any significant distortion in the findings. Most studies have identified critical reasons for negative attitudes towards vaccination, including a lack of information about vaccines, concerns about vaccine safety, and fear of potential adverse events [24,25,27,35]. In particular, several authors have noted that patients express fears that vaccination could exacerbate existing conditions such as IBD and other chronic illnesses [24,26,27,33].…”

“…Furthermore, patients using certain medications appear to prefer avoiding vaccination [24,28,30]. Specifically, Cao Y. et al [25] observed that IBD patients on biologics might be more inclined to avoid COVID-19 vaccinations, while those on 5-ASA treatment showed a greater willingness to be vaccinated. In contrast, Kwon H.J.…”

“…In this context, various strategies have been highlighted to enhance immunization coverage. Numerous authors [24][25][26][27][28][29][30]32,34,35] underscored the pivotal role of healthcare providers, particularly gastroenterologists. Trust in healthcare professionals as reliable sources of information regarding COVID-19 vaccine safety emerges as a robust predictor of vaccine acceptance.…”