Immunogenicity of Quadrivalent Influenza Vaccine for Patients with Inflammatory Bowel Disease Undergoing Immunosuppressive Therapy

Shirai, Shimpei; Hara, Megumi; Sakata, Yasuhisa; Tsuruoka, Nanae; Yamamoto, Kazuhiko; Shimoda, Ryo; Gomi, Yasuo; Yoshii, Hironori; Fujimoto, Kazuma; Iwakiri, Ryuichi

doi:10.1093/ibd/izx101

Cited by 38 publications

(44 citation statements)

References 27 publications

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“…Although antibody titers only increase slightly after repeated annual influenza vaccination, they still prevent laboratory proven influenza infections [ 35 ]. Several previous studies have shown decreased immune responses to influenza vaccination in IBD patients using anti-TNFα agents [ 6 , 7 , 11 , 12 , 13 ]. This is in line with our results from the HI assay, but not reflected by our T-cell proliferation data.…”

Section: Discussionmentioning

confidence: 99%

“…Vaccination against influenza reduces the risk of infection in immunocompromised patients [ 4 ]. However, influenza vaccination may be less effective in patients treated with immunosuppressive therapies [ 5 , 6 , 7 ] and immunological mechanisms of the impaired vaccination response in IBD patients are often poorly understood [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Adalimumab is a frequently prescribed anti-TNFα agent that is administered subcutaneously and has proven efficacy for CD since 2006 [ 9 ]. The use of anti-TNFα agents and immunomodulators, especially when used combined, is associated with a lower serological response to influenza vaccination in both children and adults with IBD [ 5 , 6 , 7 , 10 , 11 , 12 , 13 ]. This is explained by the involvement of TNFα in B-cell and T-cell interactions to achieve adequate antibody production [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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High Immunogenicity to Influenza Vaccination in Crohn’s Disease Patients Treated with Ustekinumab

et al. 2020

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Influenza vaccination can be less effective in patients treated with immunosuppressive therapy. However, little is known about the effects of ustekinumab; an anti-IL-12/23 agent used to treat Crohn’s disease (CD), on vaccination response. In this prospective study, we assessed immune responses to seasonal influenza vaccination in CD patients treated with ustekinumab compared to CD patients treated with anti-TNFα therapy (adalimumab) and healthy controls. Humoral responses were assessed with hemagglutinin inhibition (HI) assays. Influenza-specific total CD3+, CD3+CD4+, and CD3+CD8+ T-cell responses were measured with flow cytometry. Fifteen patients treated with ustekinumab; 12 with adalimumab and 20 healthy controls were vaccinated for seasonal influenza in September 2018. Seroprotection rates against all vaccine strains in the ustekinumab group were high and comparable to healthy controls. Seroconversion rates were comparable, and for A/H3N2 highest in the ustekinumab group. HI titers were significantly higher in the ustekinumab group and healthy controls than in the adalimumab group for the B/Victoria strain. Post-vaccination T-cell responses in the ustekinumab group were similar to healthy controls. One-month post-vaccination proliferation of CD3+CD8+ T-cells was highest in the ustekinumab group. In conclusion, ustekinumab does not impair immune responses to inactivated influenza vaccination. Therefore, CD patients treated with ustekinumab can be effectively vaccinated for seasonal influenza

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Immunogenicity to Influenza Vaccination in Crohn’s Disease Patients Treated with Ustekinumab

et al. 2020

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“…Although the MHRA does not list immunosuppression as a contraindication to the BNT162b2, ChAdOx1 nCoV-19, or mRNA-1273 vaccines, it does indicate that there is a theoretical possibility that immunosuppressive drugs could reduce the effectiveness of the vaccines, based on evidence from studies looking at the effect of immunosuppression on the immunogenicity of vaccines used for other infectious diseases ( figure 2 ). Infliximab monotherapy is linked to impaired induction of protective immunity following hepatitis B virus (HBV), 16 hepatitis A virus (HAV), 17 pneumococcal, 14 , 21 and influenza 18 , 22 , 23 vaccination, which might be more pronounced when anti-TNF therapy is combined with immunomodulators such as thiopurines or methotrexate. 24 , 25 Vedolizumab, which has a gut-specific mechanism of action, does not hinder HBV or influenza vaccination, but is associated with impaired antibody responses to cholera toxin, administered orally.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 vaccination for patients with inflammatory bowel disease: a British Society of Gastroenterology Inflammatory Bowel Disease section and IBD Clinical Research Group position statement

Alexander

Moran

Gaya

et al. 2021

The Lancet Gastroenterology & Hepatology

123

137

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SARS-CoV-2 has caused a global health crisis and mass vaccination programmes provide the best opportunity for controlling transmission and protecting populations. Despite the impressive clinical trial results of the BNT162b2 (Pfizer/BioNTech), ChAdOx1 nCoV-19 (Oxford/AstraZeneca), and mRNA-1273 (Moderna) vaccines, important unanswered questions remain, especially in patients with pre-existing conditions. In this position statement endorsed by the British Society of Gastroenterology Inflammatory Bowel Disease (IBD) section and IBD Clinical Research Group, we consider SARS-CoV-2 vaccination strategy in patients with IBD. The risks of SARS-CoV-2 vaccination are anticipated to be very low, and we strongly support SARS-CoV-2 vaccination in patients with IBD.Based on data from previous studies with other vaccines, there are conceptual concerns that protective immune responses to SARS-CoV-2 vaccination may be diminished in some patients with IBD, such as those taking anti-TNF drugs. However, the benefits of vaccination, even in patients treated with anti-TNF drugs, are likely to outweigh these theoretical concerns. Key areas for further research are discussed, including vaccine hesitancy and its effect in the IBD community, the effect of immunosuppression on vaccine efficacy, and the search for predictive biomarkers of vaccine success.

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“…No substantial humoral response No need to alter therapy for vaccination; administer vaccine irrespective of last dose 8,[12][13][14][15]…”

mentioning

confidence: 99%

Influenza Vaccination Recommendations During Use of Select Immunosuppressants for Psoriasis

Kim

Dao

2020

Cutis

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Immunogenicity of Quadrivalent Influenza Vaccine for Patients with Inflammatory Bowel Disease Undergoing Immunosuppressive Therapy

Abstract: Single dose QIV showed sufficient immunogenicity in patients with inflammatory bowel disease, and a boost in immunization by additional vaccination was not obtained. Additionally, immunogenicity was low in patients receiving infliximab therapy.

Cited by 38 publications

References 27 publications

High Immunogenicity to Influenza Vaccination in Crohn’s Disease Patients Treated with Ustekinumab

High Immunogenicity to Influenza Vaccination in Crohn’s Disease Patients Treated with Ustekinumab

SARS-CoV-2 vaccination for patients with inflammatory bowel disease: a British Society of Gastroenterology Inflammatory Bowel Disease section and IBD Clinical Research Group position statement

Influenza Vaccination Recommendations During Use of Select Immunosuppressants for Psoriasis

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