{Reference Type}: Journal Article
{Title}: Serologic Response and Safety after a Third Dose of the COVID-19 BNT162b2 Vaccine in Patients with Inflammatory Bowel Diseases.
{Author}: Edelman-Klapper H;Rabinowitz KM;Zittan E;Bar-Gil Shitrit A;Goren I;Avni-Biron I;Ollech JE;Lichtenstein L;Banai-Eran H;Yanai H;Snir Y;Pauker MH;Friedenberg A;Levy-Barda A;Broitman Y;Ben Zvi H;Perets TT;Eliakim R;Barkan R;Goren S;Cohen D;Dotan I; ;
{Journal}: Vaccines (Basel)
{Volume}: 11
{Issue}: 7
{Year}: 2023 Jul 20
{Factor}: 4.961
{DOI}: 10.3390/vaccines11071263
{Abstract}: Vaccines are pivotal for control of the coronavirus disease (COVID-19) pandemic. Patients with inflammatory bowel diseases (IBDs) treated with antitumor necrosis factor (TNF)-α have lower serologic response after two COVID-19 vaccine doses. Data regarding a third vaccine dose are scarce. An Israeli multicenter prospective observational study recruited 319 subjects: 220 with IBD (79 treated with anti-TNFα) and 99 healthy control (HC) participants. All patients received two mRNA-BNT162b2 vaccines (Pfizer/BioNTech), 80% of whom received a third vaccine dose. Evaluation included disease activity, anti-spike (S) and nucleocapsid (N) antibody levels, anti-TNFα drug levels, and adverse events (AEs). All participants showed significant serologic response one month after receiving a third dose. However, three months later, the anti-S levels decreased significantly in patients treated with anti-TNFα compared with the non-anti-TNFα and HC groups. A correlation between serologic response to the third vaccine dose and anti-TNF drug levels was not found. No significant AE or IBD exacerbation was observed. Importantly, lower serologic response after the third vaccine dose predicted infection. A third dose of BNT162b2 is effective and safe in patients with IBD. Lower serologic response predicted infection, even in seropositive subjects. Lower serologic responses and their rapid decline suggest a fourth vaccine dose in this patient population.