With the SARS-CoV-2 virus continuing to affect the world, it’s recommended that people with inflammatory bowel disease (IBD, Crohn’s disease, ulcerative colitis, or indeterminate colitis) get vaccinated.
People with IBD have concerns about being vaccinated, especially those who are receiving medications like immunosuppressives and biologics. The good news is that people with IBD, for the most part, will have a good response to the vaccines.
The way some IBD medications work is to suppress the immune system. However, the way these drugs affect the immune system is in a narrow, specific way. Usually, this doesn’t affect having a good response to a vaccine.
A study of 122 patients with IBD showed that 97% developed antibodies to the virus that causes COVID-19. The level of antibodies may be lower in certain patients receiving IBD medications, when compared to those who weren’t taking any IBD drugs. The vaccines in this study were Moderna and Pfizer. 
Another study showed that people with IBD who take drugs called immune-modifying therapies (biologics, JAK inhibitors, immunomodulators, or corticosteroids) may have lower antibodies if they receive the Johnson & Johnson vaccine (which is 1 dose). 
Side effects of the COVID-19 vaccines are common, but they’re also expected. The goal is to have a specific and narrow response by the immune system which helps protect against infection with the SARS-CoV-2 virus. In one study of about 250 adults with IBD, the common side effects were injection site symptoms (pain/swelling/redness), fatigue or malaise, headache/dizziness/lightheadedness, and fever or chills.
The authors of the study say that these were all similar to the reactions by people who received a vaccine and don’t live with an IBD. However, the authors also make a note that the patients in this study were not racially or ethnically diverse (5% identified as Black/African American, 6% as Hispanic/LatinX, and 2% as Asian). 
What About Boosters?
Booster doses are available now to all adults, 6 months after having their second dose of the Moderna of Pfizer vaccines. How people with IBD respond to boosters and their antibody response isn’t yet known, but it’s recommended to get the third dose when eligible.
As always, people with IBD should check with their own medical team about the COVID-19 vaccine and any other vaccines that might be needed.
Leaders In COVID-19 Vaccine Information on Twitter:
The International Foundation for the study of Inflammatory Bowel Disease (IOIBD): https://twitter.com/IOIBD1
Maria T. Abreu, MD: https://twitter.com/ibddocmaria
IBD Nurse Kay: https://twitter.com/IBDPassport
David T. Rubin, MD: https://twitter.com/IBDMD
Meena Bewtra, MD, MPH, PhD: https://twitter.com/DrsMeena
The Association of Black Gastroenterologists and Hepatologists: https://twitter.com/blackingastro
Monday Night IBD: https://twitter.com/MondayNightIBD
Aline Charabaty, MD: https://twitter.com/DCharabaty
- Caldera F, Knutson KL, Saha S, et al. Humoral Immunogenicity of mRNA COVID-19 Vaccines Among Patients With Inflammatory Bowel Disease and Healthy Controls [published online ahead of print, 2021 Nov 18]. Am J Gastroenterol. 2021;10.14309/ajg.0000000000001570. doi:10.14309/ajg.0000000000001570.
- Pozdnyakova V, Botwin GJ, Sobhani K, et al. Decreased Antibody Responses to Ad26.COV2.S Relative to SARS-CoV-2 mRNA Vaccines in Patients With Inflammatory Bowel Disease. Gastroenterology. 2021;161(6):2041-2043.e1. doi:10.1053/j.gastro.2021.08.014.
- Botwin GJ, Li D, Figueiredo J, et al. Adverse events following SARS-CoV-2 mRNA vaccination among patients with inflammatory bowel disease. Preprint. medRxiv. 2021;2021.03.30.21254607. doi:10.14309/ajg.0000000000001342.