SARS-CoV-2 vaccination does not induce relapses of patients with inflammatory bowel disease

Abstract

Background Vaccination against SARS-CoV-2 is a promising strategy to protect immunocompromised IBD patients from a severe course of COVID-19. As these patients were excluded from initial clinical vaccination trials, patients frequently express concerns regarding the safety of these vaccines, especially whether vaccination might trigger IBD flares (“hit-and-run-hypothesis”).

Methods In order to assess the risk of an IBD flare after vaccination against SARS-CoV-2, an anonymous survey was performed at five German IBD centers and one patient organization (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e.V.) in August and October 2021.

Results The questionnaire was answered by 914 patients, 781 of whom reported a previous vaccination against SARS-CoV-2 (85.4%). Vaccination against SARS-CoV-2 was not associated with an increased risk of IBD flares (p=0.319) or unscheduled visits to the IBD physician (p=0.848). Furthermore, typical symptoms of an IBD flare including abdominal pain, increases in stool frequency, or rectal bleeding were not influenced by the vaccination.

Conclusion Vaccination against SARS-CoV-2 is safe in IBD patients. These results may help to reduce fears regarding the vaccination in IBD patients. Our results can help to reduce fears in IBD patients regarding the SARS-CoV-2 vaccine. A close communication between patients and physicians before and after the vaccination may be beneficial.

Zusammenfassung

Hintergrund Die Impfung gegen SARS-CoV-2 kann immunkompromittierte Patienten mit einer chronisch-entzündlichen Darmerkrankung (CED) vor einem schweren Verlauf einer COVID-19-Erkrankung schützen. Da diese Patientengruppe in den Zulassungsstudien nicht eingeschlossen wurde, werden vielfach von Patienten Sorgen im Hinblick auf die Sicherheit geäußert, insbesondere bestehen Ängste vor der Auslösung eines akuten CED-Schubs.

Methoden Zwischen August und Oktober 2021 wurde eine retrospektive Umfrage an 5 deutschen CED-Zentren und unter den Mitgliedern der „Deutschen Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e.V.“ durchgeführt, um das Auftreten eines Schubs nach SARS-CoV-2-Impfung zu erfassen.

Resultate Der Fragebogen wurde von 914 Patienten beantwortet. Von diesen haben 781 (85,4%) berichtet, mindestens eine Impfung gegen SARS-CoV-2 erhalten zu haben. Die Vakzinierung gegen SARS-CoV-2 war nicht mit einer erhöhten Frequenz an CED-Schüben (p=0,319) oder ungeplanten Vorstellungen beim CED-Behandler (p=0,848) assoziiert. Des Weiteren war die Impfung nicht mit einer erhöhten Stuhlfrequenz, vermehrten abdominellen Schmerzen oder rektalen Blutabgängen assoziiert.

Schlussfolgerungen Die Vakzinierung gegen SARS-CoV-2 war in unserem Kollektiv nicht mit einer nachfolgend gesteigerten Krankheitsaktivität der CED assoziiert. Unsere Resultate können helfen, Ängste von CED-Patienten vor einer Impfung gegen SARS-CoV-2 zu reduzieren.

Schlüsselwörter

IBD - Impfung - SARS-CoV-2 - COVID-19 - Nebeneffekt

Keywords

IBD - vaccination - SARS-CoV-2 - COVID-19 - side effect

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