Vaccines against SARS-CoV-2 are highly effective but how well do they work in people who are on immunosuppressants.
In this film I breakdown the full CLARITY IBD dataset - 7000 people with Crohn's disease and ulcerative colitis on infliximab (an anti-TNF antibody) or vedolizumab (a gut specific anti-integrin antibody that does not impair systemic immune response and is an excellent control).
We find that patients on infliximab have no increased risk of COVID.
But they have lower antibody responses to infection.
After one dose of infection patients on infliximab have only lower levels of anti-spike RBD antibodies. After two doses this rises to protective levels in the majority but is still 4 to 5 fold lower than vedolizumab treated patients.
Over time antibody levels in infliximab patients decays towards the seroconversion threshold within 14-18 weeks.
T cell responses are unaffected by infliximab therapy, but 20% of people do not mount a T cell response to either vaccine. T cell responses are uncoupled from antibody responses. That means that the majority of people with low antibody responses have protection from T cells.
PUBLICATIONS and LINKS:
The CLARITY data are available in two publications in GUT with the latest data as a preprint (under peer review)
CLARITY data on response to infection:
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CLARITY data on response to one dose of vaccine:
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CLARITY preprint on response to 2 doses of vaccine incl. T cells:
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BSG GUIDANDE ON VACCINES IN IBD
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My most recent video with further details on COVID vaccines is here
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For information from Crohn's and Colitis UK:
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CLARITY IBD:
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VIP STUDY:
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