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Gastroenterologists at the Advances in Inflammatory Bowel Disease (AIBD) 2020 Annual Meeting said they will strongly advise their patients to take the COVID-19 vaccines as they become available.
Announcement that the first vaccine, Pfizer’s, was recommended for emergency use authorization came in the middle of AIBD’s Thursday evening COVID-19 session.
Miguel Regueiro, MD, chair of Gastroenterology & Hepatology at Cleveland Clinic in Ohio, said, “We’re uniformly recommending this to all our patients.”
“The [vaccines] leading the pack do not have any replicating virus and thus can be used in immunocompromised people,” Maria Abreu, MD, director of the Crohn’s & Colitis Center at the University of Miami Miller School of Medicine, told Medscape Medical News. “Although it is true that we don’t know — and won’t know for a while — whether the high levels of efficacy seen with the mRNA vaccines so far will be achieved in patients who are immunocompromised, there is every reason to believe that [the vaccine] will still be enough to protect them from complications of COVID-19.”
The bottom line, she said, is that “it’s much safer to get a vaccine than it is to take your chances of getting COVID-19.”
David T. Rubin, MD, chief of gastroenterology, hepatology, and nutrition at UChicago Medicine, said in a session earlier in the day, “Emerging information about the messenger RNA looks like it’s going to be safe for our population, but of course we want to see more. Messenger RNA degrades within days of giving it, so it’s not expected to linger or generate any other problems we can think of.”
Abreu said there’s no evidence that IBD patients are more susceptible to COVID-19 infection even though the entry molecules are expressed in the GI tract. “They are really not differentially expressed in IBD and, if anything, some of our more potent therapies reduce the expression of these molecules in the GI tract,” she said.
Regarding how IBD medications affect outcomes if patients are infected with COVID-19, Abreu pointed out that corticosteroids seem to be associated with worse outcomes. “I would posit that it has to do with initially allowing there to be a lot of very rapid viral replication,” she said.
And she also noted that any of the mainstay drugs for IBD — the anti-TNF therapies — are showing promise as treatments for COVID-19.