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Bronsky J, Copova I, Durilova M, Kazeka D, Kubat M, Lerchova T, Vlckova E, Mitrova K, Rataj M, Klocperk A, Sediva A, Hradsky O. Postvaccination Immunogenicity of BNT162b2 SARS-CoV-2 Vaccine and Its Predictors in Pediatric Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2023; 76:e36-e44. [PMID: 36705698 PMCID: PMC9847686 DOI: 10.1097/mpg.0000000000003661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/10/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We prospectively compared the postvaccination immunity to messenger ribonucleic acid BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine of our pediatric patients over 12 years old with inflammatory bowel disease (IBD) to that of healthy controls and looked for predictors of its robustness. METHODS Anti-receptor binding domain, anti-spike S2, and anti-nucleocapsid immunoglobin-G (IgG) and immunoglobin-A levels were measured in 139 pediatric patients with IBD [65 fully vaccinated (2 doses), median age 16.3, interquartile range (IQR) 15.2-17.8 years, median time from vaccination (IQR) 61.0 (42.0-80.0) days] and 1744 controls (46, 37-57 years) using microblot array. RESULTS All IBD and control patients developed positive anti-receptor binding domain IgG antibodies at comparable titers. The proportion of observations with positive anti-spike S2 IgG was higher in patients with IBD than in controls [63% vs 21%, odds ratio 2.99 (1.51-5.90)], as was its titer [median (IQR) 485 (92-922) vs 79 [33-180] IU/mL]. Anti-receptor binding domain and anti-spike S2 IgG levels were associated with IBD status. We found an association between anti-spike S2 IgG levels and time since vaccination (β -4.85, 95% CI -7.14 to 2.71, P = 0.0001), history of SARS-CoV-2 polymerase chain reaction positivity (206.76, 95% CI 39.93-374.05, P = 0.0213), and anti-tumor necrosis factor treatment (-239.68, 95% CI -396.44-83.55, P = 0.0047). Forty-three percent of patients reported vaccination side effects (mostly mild). Forty-six percent of observations with positive anti-nucleocapsid IgG had a history of SARS-CoV-2 infection. CONCLUSIONS Patients with IBD produced higher levels of postvaccination anti-spike S2 antibodies than controls. Previous SARS-CoV-2 infection is associated with higher production of postvaccination antibodies and anti-tumor necrosis factor treatment with lower production.
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Affiliation(s)
- Jiri Bronsky
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ivana Copova
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marianna Durilova
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Denis Kazeka
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Michal Kubat
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Tereza Lerchova
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Eva Vlckova
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Katarina Mitrova
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
- the Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Rataj
- the Department of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Adam Klocperk
- the Department of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Anna Sediva
- the Department of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ondrej Hradsky
- From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Cotugno N, Franzese E, Angelino G, Amodio D, Romeo EF, Rea F, Faraci S, Tambucci R, Profeti E, Manno EC, Santilli V, Rotulo GA, Pighi C, Medri C, Morrocchi E, Colagrossi L, Pascucci GR, Valentini D, Villani A, Rossi P, De Angelis P, Palma P. Evaluation of Safety and Immunogenicity of BNT162B2 mRNA COVID-19 Vaccine in IBD Pediatric Population with Distinct Immune Suppressive Regimens. Vaccines (Basel) 2022; 10:vaccines10071109. [PMID: 35891273 PMCID: PMC9318731 DOI: 10.3390/vaccines10071109] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/20/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Patients affected by Inflammatory Bowel Disease (IBD) present higher risk for infection and suboptimal response upon vaccination. The immunogenicity of SARS-CoV2 vaccination is still largely unknown in adolescents or young adults affected by IBD (pIBD). We investigated the safety and immunogenicity of the BNT162B2 mRNA COVID-19 vaccine in 27 pIBD, as compared to 30 healthy controls (HC). Immunogenicity was measured by anti-SARS-CoV2 IgG (anti-S and anti-trim Ab) before vaccination, after 21 days (T21) and 7 days after the second dose (T28). The safety profile was investigated by close monitoring and self-reported adverse events. Vaccination was well tolerated, and short-term adverse events reported were only mild to moderate. Three out of twenty-seven patients showed IBD flare after vaccination, but no causal relationship could be established. Overall, pIBD showed a good humoral response upon vaccination compared to HC; however, pIBD on anti-TNFα treatment showed lower anti-S Ab titers compared to patients receiving other immune-suppressive regimens (p = 0.0413 at first dose and p = 0.0301 at second dose). These data show that pIBD present a good safety and immunogenicity profile following SARS-CoV-2 mRNA vaccination. Additional studies on the impact of specific immune-suppressive regimens, such as anti TNFα, on immunogenicity should be further investigated on larger cohorts.
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Affiliation(s)
- Nicola Cotugno
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00185 Rome, Italy; (A.V.); (P.R.)
| | - Enrica Franzese
- The School of Pediatrics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (E.F.); (E.P.)
| | - Giulia Angelino
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Donato Amodio
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Erminia Francesca Romeo
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Francesca Rea
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Simona Faraci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Elisa Profeti
- The School of Pediatrics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (E.F.); (E.P.)
| | - Emma Concetta Manno
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Veronica Santilli
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Gioacchino Andrea Rotulo
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16126 Genoa, Italy
| | - Chiara Pighi
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Chiara Medri
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Elena Morrocchi
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Luna Colagrossi
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Giuseppe Rubens Pascucci
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
| | - Diletta Valentini
- Pediatric Unit, Pediatric Emergency Department (DEA), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Alberto Villani
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00185 Rome, Italy; (A.V.); (P.R.)
- Pediatric Unit, Pediatric Emergency Department (DEA), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Paolo Rossi
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00185 Rome, Italy; (A.V.); (P.R.)
- Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.A.); (E.F.R.); (F.R.); (S.F.); (R.T.); (P.D.A.)
| | - Paolo Palma
- Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (N.C.); (D.A.); (E.C.M.); (V.S.); (G.A.R.); (C.P.); (C.M.); (E.M.); (G.R.P.)
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00185 Rome, Italy; (A.V.); (P.R.)
- Correspondence: ; Tel.: +39-06-6859-2697
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James D, Jena A, Bharath PN, Choudhury A, Singh AK, Sebastian S, Sharma V. Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis. Dig Liver Dis 2022; 54:713-721. [PMID: 35382972 PMCID: PMC8938236 DOI: 10.1016/j.dld.2022.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Risk of adverse effects and flare of inflammatory bowel disease (IBD) are frequently cited reasons for COVID-19 vaccine hesitancy. METHODS Electronic databases were searched to identify studies reporting the use of COVID-19 vaccine in IBD. We selected studies reporting the incidence of various adverse effects (local or systemic) and flares of IBD after COVID-19 vaccination. The pooled incidence rates for various adverse effects, stratified for the dose and the type of vaccine (adenoviral or mRNA) were estimated. RESULTS Nine studies (16 vaccination cohorts) were included. The pooled incidence rate of overall adverse events was 0.55 (95%CI, 0.45-0.64, I2= 95%). The pooled incidence rate of local adverse events was 0.64 (0.47-0.78, I2= 100%). The pooled incidence rates of fatigue, headache, myalgia, fever and chills were 0.30 (0.21-0.40, I2= 99%), 0.23 (0.17-0.30, I2= 99%), 0.18 (0.13-0.24, I2= 99%), 0.10 (0.06-0.17, I2= 98%) and 0.15 (0.06-0.3, I2= 86%), respectively. The pooled incidence rates of severe adverse events, adverse events requiring hospitalization and flares of IBD following COVID-19 vaccination were 0.02 (0.00-0.12, I2= 97%), 0.00 (0.00-0.01, I2= 27%) and 0.01 (0.01-0.03, I2= 45%), respectively. CONCLUSION COVID-19 vaccination in patients with IBD appears to be safe with only mild adverse events. Flares of IBD and severe adverse events requiring hospitalization were infrequent.
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Affiliation(s)
- Deepak James
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuraag Jena
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pardhu Neelam Bharath
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arup Choudhury
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam K Singh
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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