Patients with inflammatory bowel disease (IBD) should be vaccinated against SARS-CoV-2, according to recommendations issued by the International Organization for the Study of Inflammatory Bowel Disease (IOIBD). Patients with IBD and other immune-related conditions were excluded from SARS-CoV-2 vaccine trials, leaving many questions regarding the safety and effectiveness of SARS-CoV-2 vaccination in IBD patients. The IOIBD is a global organization of IBD clinician-researchers from 27 countries. In March 2020, IOIBD developed recommendations for the clinical management of patients with IBD during the COVID-19 pandemic. The group reconvened in December to develop specific recommendations pertaining to the use of SARS-CoV-2 vaccines in IBD populations. According to the recommendations online now in the journal Gut, all patients with IBD should be vaccinated "as soon as they are able to receive the vaccine, regardless of immune-modifying therapies." "The best time to administer SARS-CoV-2 vaccination in patients with IBD is at the earliest opportunity to do so," the panel says. "SARS-CoV-2 vaccines including messenger RNA vaccines, replication-incompetent vector vaccines, inactivated vaccines and recombinant vaccines are safe to administer to patients with IBD. The exception is for any live-attenuated virus vaccines or replication-competent viral vector vaccines that come to market," the panel notes. They say SARS-CoV-2 vaccination should not be deferred because a patient with IBD is receiving immune-modifying therapies. They advise counseling patients with IBD that the efficacy of the vaccine may be decreased in the setting of systemic corticosteroid therapy. The paper lists 44 statements and discusses nuances with each. "The overarching theme of these statements is that people with IBD should be vaccinated according to their overall risk of exposure to and risk of complications from SARS-CoV-2," the panel says. The panel also notes that both development of the statements as well as the consensus responses are "limited by the lack of available data and are based on expert opinion, including guidance from a vaccinologist." "Despite data gaps, the global IBD patient and professional communities need guidance in the face of such uncertainty. These consensus statements are meant to inform clinical decision-making but should not replace individualized management decisions. Real-world data from registries will help generate data on vaccine outcomes in patients with IBD to inform future recommendations," the panel concludes. —Reuters staff Source
