Humoral Immune Response and Safety of SARS-CoV-2 Vaccination in Pediatric Inflammatory Bowel Disease

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  • Kastl A.J.
    • Other Affiliation: Children’s Hospital of Philadelphia
  • Weaver K.N.
    • Affiliation: School of Medicine, Department of Medicine
  • Zhang X.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Strople J.A.
    • Other Affiliation: Ann & Robert H. Lurie Children’s Hospital of Chicago
  • Adler J.
    • Other Affiliation: University of Michigan
  • Dubinsky M.C.
    • Other Affiliation: Icahn School of Medicine
  • Bousvaros A.
    • Other Affiliation: Harvard Medical School
  • Watkins R.
    • Other Affiliation: University of Maryland School of Medicine
  • Dai X.
    • Affiliation: School of Medicine, Department of Medicine
  • Chen W.
    • Affiliation: School of Medicine, Department of Medicine
  • Cross R.K.
    • Other Affiliation: University of Maryland School of Medicine
  • Higgins P.D.R.
    • Other Affiliation: University of Michigan
  • Ungaro R.C.
    • Other Affiliation: Icahn School of Medicine
  • Bewtra M.
    • Other Affiliation: Northwestern University
  • Bellaguarda E.A.
    • Other Affiliation: Mayo Clinic
  • Farraye F.A.
    • Other Affiliation: LabCorp
  • Chun K.Y.
    • Other Affiliation: LabCorp
  • Zikry M.
    • Other Affiliation: LabCorp
  • Fernando M.
    • Other Affiliation: LabCorp
  • Bastidas M.
    • Other Affiliation: LabCorp
  • Hernandez C.G.
    • Affiliation: School of Medicine
  • Craig R.G.
    • Affiliation: School of Medicine
  • Boccieri M.E.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Firestine A.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Long M.D.
    • Affiliation: School of Medicine, Department of Medicine
  • Kappelman M.D.
    • Affiliation: School of Medicine, Department of Pediatrics
Abstract
  • INTRODUCTION:Children with inflammatory bowel disease (IBD) may respond differently to COVID-19 immunization as compared with healthy children or adults with IBD. Those younger than 12 years receive a lower vaccine dose than adults. We sought to describe the safety and humoral immune response to COVID-19 vaccine in children with IBD.METHODS:We recruited children with IBD, ages 5-17 years, who received ≥ 2 doses of the BNT162b2 vaccine by a direct-to-patient outreach and at select sites. Patient demographics, IBD characteristics, medication use, and vaccine adverse events were collected. A subset of participants had quantitative measurement of anti-receptor binding domain IgG antibodies after 2-part immunization.RESULTS:Our study population included 280 participants. Only 1 participant required an ED visit or hospitalization because of an adverse event. Of 99 participants who underwent anti-receptor binding domain IgG antibody measurement, 98 had a detectable antibody, with a mean antibody level of 43.0 g/mL (SD 67) and a median of 22 g/mL (interquartile range 12-38). In adjusted analyses, older age (P = 0.028) and antitumor necrosis factor monotherapy compared with immunomodulators alone (P = 0.005) were associated with a decreased antibody level. Antibody response in patients treated with antitumor necrosis factor combination vs monotherapy was numerically lower but not significant.DISCUSSION:Humoral immune response to COVID-19 immunization in children with IBD was robust, despite a high proportion of this pediatric cohort being treated with immunosuppressive agents. Severe vaccine-related AEs were rare. Overall, these findings provide a high level of reassurance that pediatric patients with IBD respond well and safely to SARS-CoV-2 vaccination.
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Resource type
  • Article
Journal title
  • American Journal of Gastroenterology
Journal volume
  • 118
Journal issue
  • 1
Page start
  • 129
Page end
  • 137
Language
  • English
Funder
  • Leona M. and Harry B. Helmsley Charitable Trust
ISSN
  • 0002-9270
Publisher
  • Wolters Kluwer Health

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