COVID-19 Vaccine Booster Dose Willingness among Patients with Inflammatory Bowel Disease on Infliximab and Vedolizumab: A Cross-Sectional Study

Abstract

Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive a third (booster) dose among patients with inflammatory bowel disease (IBD). Methods: A cross-sectional study was performed at an IBD tertiary care center. Patients were recruited at the infusion room from 1 January 2022 to 31 March 2022. The primary outcome was the prevalence of a third (booster) dose of the BNT162b2 vaccine in infliximab- or vedolizumab-treated patients with IBD. The secondary outcome evaluated whether the prevalence of a third (booster) dose of the BNT162b2 vaccine differed based on type of COVID-19 vaccine, gender, age, type of biologic therapy, and citizenship. Results: In total, 499 patients with IBD were included in this study. The median age was 34.5 years, and 60% had ulcerative colitis (UC). Among the study participants, 302 (60.5%) patients were vaccinated with BNT162b2, and 197 (39.5%) were vaccinated with ChAdOx1 nCoV-19. Of the total number of participants, 400 (80.2%) were receiving infliximab, and 99 (19.8%) were receiving vedolizumab. Overall, 290 (58.1%) of the included patients were willing to receive the third (booster) dose. Patients vaccinated with BNT162b2 were more likely to be willing to receive a booster dose compared to patients vaccinated with ChAdOx1 nCoV-19 (201 (66.5%) vs. 103 (52.0%), p = 0.014). Infliximab-treated patients were more likely to be willing to receive a booster dose compared to patients receiving vedolizumab (310 (77.5%) vs. 62 (62.6%), p = 0.002). There was no statistical difference in willingness to receive a booster dose in terms of age, nationality, or gender. Conclusions: The percentage of patients with IBD willing to receive or having already received a third (booster) dose of BNT162b2 vaccine was lower compared to the general population. In addition, patients who received two doses of BNT162b2 vaccines were more likely to be willing to receive a third (booster) dose compared to patients who received ChAdOx1 nCoV-19. Patients treated with infliximab were more likely to be willing to receive a third (booster) dose of COVID-19 vaccine.

COVID-19 Booster Vaccine Hesitancy among Hemodialysis Patients in Saudi Arabia Using the Health Belief Model: A Multi-Centre Experience

“…A recent study survey from China among 350 CKD patients showed that around 70.29% of the respondents reported their willingness to receive a COVID-19 booster vaccine dose [ 19 ]. When compared to a recent study conducted among patients with another chronic medical condition (inflammatory bowel disease) in Kuwait that reported only 58.1% acceptance, the willingness to receive a COVID-19 vaccination booster dose was higher in our study [ 22 ]. Another study among healthcare workers in SA found that 71.1% of study participants reported positive intent for receiving a COVID-19 booster dose, which is lower than in our study [ 20 ].…”

Why Some People Are Hesitant to Receive COVID-19 Boosters: A Systematic Review

“…However, another investigation showed that booster hesitancy was higher among those who received Pfizer vaccines [ 5 ]. Seboka et al [ 13 ] and Shehab et al [ 46 ] found higher booster hesitancy among people receiving the AstraZeneca vaccine. On the contrary, Al-Qerem et al [ 29 ] reported lower booster hesitancy among AstraZeneca recipients.…”

Adherence to Recommended Immunization Schedules in Patients with Inflammatory Bowel Disease on Biologics and Small Molecule Therapies

“…In line with our findings, other studies have also identified specific factors influencing COVID-19 vaccination rates in IBD patients. Female patients, those above the age of 50, and expatriates were more likely to receive COVID-19 vaccines [46,47]. Similarly, a study by Kwon et al observed higher vaccination uptake among IBD patients who were on biologics and of white or Asian race.…”