Serological Responses to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease
Date
2022-05-18
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Abstract
Inflammatory bowel disease (IBD) refers to a group of disorders characterized by chronic inflammation and ulceration of the gastrointestinal tract. In context of the ongoing COVID-19 pandemic, individuals with IBD have an increased risk of hospitalization from COVID-19 and certain IBD therapies are related to increased risks of infection and severe disease. Although SARS-CoV-2 vaccines can mitigate infection risk, individuals with IBD may have reduced serological responses based on their condition and use of immunosuppressive medications. Therefore, we investigated serological responses following 1st, 2nd, and 3rd doses of SARS-CoV-2 vaccination.A prospective cohort study of persons with IBD in the Calgary area (n = 496) assessed serological response at the following timepoints: 1–8 weeks after 1st dose vaccination, 1–8 weeks after 2nd dose, eight or more weeks after 2nd dose, and at least one week after 3rd dose. Seroconversion and geometric mean titer (GMT) with 95% confidence intervals were assessed for antibodies to the SARS-CoV-2 spike protein using the Abbott Architect SARS-CoV-2 IgG II Quant Assay. Multivariable linear regression models assessed the impact of age, sex, IBD type, medication class, vaccine schedule, prior SARS-CoV-2 infection, and time following vaccination on antibody concentration following each dose of vaccine. Seroconversion and GMT increased consecutively with each dose of vaccine, with the highest values corresponding to after 3rd dose vaccination. Older age and several medication classes were related to decreased antibody titres post-2nd dose, whereas use of prednisone was the only factor associated with diminished antibody response after 3rd dose vaccination. Antibody levels steadily decline following the 2nd and 3rd doses of SARS-CoV-2 vaccination. In this thesis, we aimed to evaluate serological responses to SARS-CoV-2 vaccination and were able to determine a robust antibody response to a three-dose regimen across all classes of IBD therapies except for prednisone. Decaying antibody levels following 3rd dose vaccination should be monitored in future studies and other measures of vaccine-induced protection against SARS-CoV-2 such as neutralizing antibodies, T-cell responses, and vaccine effectiveness should be evaluated. In conclusion, three-dose SARS-CoV-2 vaccine regimens induce substantial immunogenicity in those with IBD and should be emphasized for serological protection.
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Keywords
Inflammatory bowel disease, SARS-CoV-2 vaccination, Crohn's disease, ulcerative colitis
Citation
Quan, J. (2022). Serological Responses to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease (Master thesis). University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca .