S2478 SARS-CoV Vaccination and IBD

Introduction:

We have limited data on the response of the SARS-CoV2 vaccine on patients on immunosuppressive therapies. However, there is concern that the vaccination may not be as effective based on preliminary information from transplant patients. In inflammatory bowel disease, many patients are on biologic therapies to maintain remission. Although the currently approved vaccines are considered safe to use in immunosuppression as they are killed vaccines, we have limited data on the effectiveness in preventing COVID infection in individuals with inflammatory bowel disease (IBD).

Case Description/Methods:

We present a case report on a 39-year-old female with Crohn's disease who was vaccinated against COVID using the Pfizer vaccine. Two months after vaccination, she developed symptoms of COVID of fever, abdominal cramping, and nausea. She recovered without any sequelae after 8 days. She has been on adalimumab 40mg every two weeks since 2016, previously on vedolizumab, but had worsening gastroparesis. SARS-COV2 antibody titers were not evaluated in this patient after vaccination or before her known infection. Although this was reported in only one of our patients seen in our tertiary referral IBD center, this raises concern of lower efficacy of the SARS-CoV2 vaccination in those on biologic therapy especially anti-TNF treatment such as adalimumab.

Discussion:

Further evaluation on vaccine response should be considered for future research and our IBD patients on immunosuppressive therapy must be educated on the possibility of getting COVID after exposure despite vaccination. Furthermore, this case highlights the individualization of care that should be provided for individuals with IBD amidst a pandemic.