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- Statement SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
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Yoo Jin Lee1,*
, Seong-Eun Kim2,*, Yong Eun Park3, Ji Young Chang4, Hyun Joo Song5, Duk Hwan Kim6, Young Joo Yang7, Byung Chang Kim8, Jae Gon Lee9, Hee Chan Yang10, Miyoung Choi11, Seung-Jae Myung12, The Clinical Practice Guideline Committee of the Korean Association for the Study of the Intestinal Diseases (KASID) -
Intestinal Research 2022;20(2):171-183.
DOI: https://doi.org/10.5217/ir.2021.00098
Published online: January 5, 2022
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
2Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
3Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
4Department of Health Promotion Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
5Division of Gastroenterology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University College of Korea, Jeju, Korea
6Digestive Disease Center, CHA Bundang Hospital, CHA University, Seongnam, Korea
7Division of Gastroenterology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
8Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
9Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
10Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
11Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
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- Correspondence to Seung-Jae Myung, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3917, Fax: +82-2-476-0824, E-mail: sjmyung@amc.seoul.kr
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*These authors contributed equally to this study.
This guideline is being co-published in Intestinal Research (in English) and the orean Journal of Gastroenterology (in Korean) for the facilitated distribution.
• Received: July 12, 2021 • Revised: August 21, 2021 • Accepted: August 22, 2021
© Copyright 2022. Korean Association for the Study of Intestinal Diseases. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
- Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.
INTRODUCTION
GENERAL ISSUES AND SAFETY
EFFICACY
SARS-CoV-2 VACCINATION FOR PREGNANT AND LACTATING WOMEN
CONCLUSION
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Funding Source
The authors received no financial support for the research, authorship, and/or publication of this article.
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Conflict of Interest
Myung SJ is an editorial board member of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.
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Author Contribution
Conceptualization: Myung SJ. Data curation: Lee YJ, Kim SE, Park YE, Choi M. Formal analysis: Kim SE, Choi M. Methodology: Kim SE, Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Choi M. Project administration: Kim SE, Myung SJ. Resources: Myung SJ. Supervision: Myung SJ. Validation: Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Myung SJ. Visualization: Lee YJ, Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Choi M. Writing - original draft: Lee YJ, Kim SE. Writing - review & editing: Lee YJ, Kim SE, Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Choi M. Approval of final manuscript: all authors.
NOTES
Table 1.Consensus Statements on SARS-CoV-2 Vaccination for Adult IBD Patients by KASID
The response scale is a 9-Likert scale, ranging from 1 point (strongly disagree) to 9 points (strongly agree), and the closer to 9, the higher strength of agreement.
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; IBD, inflammatory bowel disease; KASID, the Korean Association for the Study of Intestinal Diseases; COVID-19, coronavirus disease 2019; SD, standard deviation; CV, coefficient of variation (SD/mean)
Table 2.SARS-CoV-2 Vaccines Currently Available in Korea as of Date of July 10, 2021
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; mRNA, messenger RNA; COVID-19, coronavirus disease 2019; IM, intramuscular.
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SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
| Accepted statements | Strength of agreement (mean) | SD | CV |
|---|---|---|---|
| 1. SARS-CoV-2 vaccination is strongly recommended for IBD patients. | 8.5 | 0.60 | 0.07 |
| 2. There is no evidence that the currently used non-live vaccines increase the risk of SARS-CoV-2 infection or IBD aggravation. The same level of caution is required for vaccine side effects in these patients as in the general population. | 8.3 | 0.59 | 0.07 |
| 3. SARS-CoV-2 vaccination is recommended for IBD patients who are being treated with immune-modifying drugs, including biologics and small molecule inhibitors. | 8.0 | 0.70 | 0.09 |
| 4. IBD patients being treated with biologic agents can be vaccinated against SARS-CoV-2 irrespective of the timing of drug administration. | 7.7 | 0.76 | 0.10 |
| 5. The efficacy of SARS-CoV-2 vaccination in IBD patients may vary depending on the therapeutic agent used. | 8.3 | 0.67 | 0.08 |
| 6. In patients with IBD on high-dose systemic corticosteroid therapy, the efficacy of a SARS-CoV-2 vaccine may be reduced. Therefore, consultation with medical staff is needed for the appropriate timing of vaccination. | 8.2 | 0.78 | 0.10 |
| 7. Influenza and pneumococcal vaccinations are highly recommended for IBD patients in the COVID-19 pandemic era. | 8.6 | 0.55 | 0.06 |
| 8. Even after SARS-CoV-2 vaccination, personal hygiene practices and public health recommendations should be followed strictly to prevent infection. | 8.9 | 0.43 | 0.05 |
| 9. SARS-CoV-2 vaccination in pregnant IBD patients is recommended, similar as for pregnant women in the general population, in accordance with the government vaccination policy. | 7.9 | 0.71 | 0.09 |
| 10. In lactating IBD patients, SARS-CoV-2 vaccination is recommended, as with lactating women in the general population, in accordance with the government vaccination policy. | 7.9 | 0.71 | 0.09 |
| 11. It is recommended that IBD patients who are planning to become pregnant receive the SARS-CoV-2 vaccine prior to pregnancy. However, do not delay pregnancy for vaccination. | 7.8 | 0.84 | 0.11 |
| Type of vaccine | mRNA vaccine | Virus vector vaccine | ||
|---|---|---|---|---|
| Manufacturing company | Pfizer-BioNTech | Moderna | AstraZeneca | Janssen Johnson & Johnson |
| Name | Comirnaty | - | COVID-19 vaccine AstraZeneca | Janssen COVID-19 vaccine |
| Authorized age groups | ≥ 16 years of age | ≥ 18 years of age | ≥ 18 years of age | ≥ 18 years of age |
| Doses per vial | Multiple doses (6) per vial | Multiple doses (10) per vial | Multiple doses (10) per vial | Multiple doses (5) per vial |
| Schedule | 2 Doses (3 weeks apart) | 2 Doses (4 weeks apart) | 2 Doses (8–12 weeks apart) | 1 Dose |
| Dosing | 0.3 mL IM (diluted) | 0.5 mL IM | 0.5 mL IM | 0.5 mL IM |
| Storage | –90°C to –60°C (6 months) | –25°C to –15°C (7 months) | 2°C to 8°C (6 months) | –25°C to –15°C (24 months) |
| Transport | –90°C to –60°C (6 months)/2°C to 8°C (5 days) | 2°C to 8°C (30 days) | 2°C to 8°C (6 months) | 2°C to 8°C (3 months) |
| After first use | 2°C to 25°C, 6 hours (diluted) | Room temperature, 6 hours | Room temperature (under 30°C), 6 hours | 2°C to 8°C, 6 hours/room temperature (under 25°C), 3 hours |
Table 1. Consensus Statements on SARS-CoV-2 Vaccination for Adult IBD Patients by KASID
The response scale is a 9-Likert scale, ranging from 1 point (strongly disagree) to 9 points (strongly agree), and the closer to 9, the higher strength of agreement. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; IBD, inflammatory bowel disease; KASID, the Korean Association for the Study of Intestinal Diseases; COVID-19, coronavirus disease 2019; SD, standard deviation; CV, coefficient of variation (SD/mean)
Table 2. SARS-CoV-2 Vaccines Currently Available in Korea as of Date of July 10, 2021
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; mRNA, messenger RNA; COVID-19, coronavirus disease 2019; IM, intramuscular. Korea Disease Control and Prevention Agency (
