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Covid-19 vaccination for IBD patients

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Inflammatory bowel disease (ulcerative colitis and Crohn's disease) is chronic immuno-inflammatory relapses diseases that accompany the patient throughout his life. 
 
Most patients with inflammatory bowel disease (IBD) receive lifetime immunosuppressive or biological therapy.
  • She reduces immune system activity.
 
But this entails high risk development infectious diseases:
  • flu, 
  • tuberculosis, pneumococcal and cytomegalovirus infections,
  • herpes virus, 
  • Epstein-Barr virus et al. 
 
Currently in Russia, a mass vaccination against the new coronavirus infection SARS-CoV-2. 
  • How much is it safe for patients with IBD?
For this category of patients in 2021 were released recommendations developed by the working group of the expert council All-Russian society for the study of inflammatory bowel diseases (In IBD) taking into account official positions international medical communities.
 
1.  Patients with IBD, including patients over 60 years old and patients with intestinal stoma, must be vaccinated against SARS-CoV-2 regardless of the disease (ulcerative colitis or Crohn's disease) and type of therapy. 
  • Necessity surveys the patient before vaccination is determined by the Attending Physician.
 
2.  Patients with IBD who are in Phase remissions, and patients with minimal or moderate activity inflammation vaccination it is shown almost without restrictions. 
  • In patients with severe inflammatory activity, the doctor's recommendation and the patient's decision on vaccination should be based on a comprehensive assessment of the benefit–risk ratio
  • The benefit of the expected response to the vaccine (reduced risks of infection and more severe covid-19) should outweigh the possible risk of adverse events associated with vaccination.
 
3. In patients with IBD receiving any immunosuppressive therapy including the use of systemic corticosteroids, immunosuppressants and biologics, there are no contraindications to vaccination. 
  • However, keep in mind that immunosuppression caused by these drugs, may reduce the effectiveness of vaccination (the possible risk of a partial reduction in response to the vaccine should be taken into account.) 
  • In this regard, vaccination preferably (if possible). before appointment specified groups drugs or during the period when therapy with these drugs is carried out in the lowest possible doses.
 
4. Various vaccines against SARS-CoV-2 safe for use in patients with IBD.
  • But it should avoid use in patients with IBD receiving immunosuppressive therapy, alive (attenuated) vaccines and vaccines based on replicating viral vectors.
 
5. Women with IBD planning to pregnancy, follows recommend vaccination against SARS-CoV-2 before conception. 
  • Pregnant women with IBD vaccination can be carried out in accordance with history in the country recommendations for pregnant women without IBD and with permission obstetrician-gynecologist.
 
6. Patients with IBD with confirmed transferred coronavirus infection recommended definition titer of IgG antibodies to SARS-CoV-2 serum every 3 months. 
  • Vaccination recommended when IgG levels are significantly reduced SARS-CoV-2 (or lack thereof) and persistence unfavorable the epidemiological situation of COVID-19.
  • Important to note: Due to the use of different test systems when referring a patient to a study to determine the titer of antibodies, the doctor must necessarily indicate: the specific purpose of the study:
    • determination of the level of antibodies after transferred coronavirus infection
    • or after vaccination against SARS-CoV-2.
The importance of vaccination should be discussed with your doctor. at the time of diagnosis inflammatory bowel disease.
  • This will help prevent development serious infectious diseases.
 
In the MCSC named after A. S. Loginov, treatment and monitoring of patients with ulcerative colitis and Crohn's disease is carried out in the IBD Department with the involvement of doctors of various specialties. 
 
Early access to our specialists allows us to prescribe adequate modern therapy in a timely manner, taking into account the assessment of the individual characteristics of each patient.
 
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