key: cord-0687236-sogsjzhi
authors: Melmed, Gil; Rubin, David T.; McGovern, Dermot
title: Reply
date: 2021-04-05
journal: Gastroenterology
DOI: 10.1053/j.gastro.2021.03.054
sha: 8f76adc50172d5633e5d6760ed4b9f16617c48b6
doc_id: 687236
cord_uid: sogsjzhi

nan

Reply. We thank Papa et al for their thoughtful comments on our commentary. The broad considerations about these new vaccines are being actively discussed in many populations, and Papa et al outline very important concerns. First, we agree with their assessment that the exclusion of patients with inflammatory bowel disease (IBD) who are receiving immune therapies in the vaccine pivotal trials renders it difficult to extrapolate the safety and efficacy of the available SARS-CoV-2 vaccines in this patient population. This underscores a critical urgency to enroll patients into real-world registries to capture vaccine responses among those with IBD, particularly among those on immunosuppressive or biologic therapies. It will be important, however, not just to understand vaccine safety and effectiveness in the IBD population, but also to compare these outcomes against non-IBD populations outside the clinical trials. An uncontrolled study among organ transplant recipients receiving antimetabolite therapies showed low serologic responses to a single dose of messenger RNA vaccination, but it is unclear whether and how this should be understood in the context of the recommended 2-dose series and without a healthy comparator group assessed at this early timepoint. 1

Second, we agree that patients with IBD hesitant to receive anti-SARS-CoV-2 vaccination may look to their gastroenterologists for immunization guidance, as has been shown in a pre-COVID-19 patient survey. 2 It behooves the practitioner to understand patients' concerns and the root of their hesitancy. This hesitancy may naturally improve over time with the publication and dissemination of what we anticipate will be reassuring outcomes data generated by the aforementioned realworld registries. However, some patients may require educational messaging that might be optimally delivered by social media or video campaigns or that may require religious or even political envoys. Finally, we acknowledge that vaccines will not provide absolute protection against SARS-CoV-2 transmission, although the data to date are overwhelmingly reassuring that recipients are protected from severe COVID-19 and that increased community uptake is associated with a reduction in viral transmission. 3 1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54  55  56  57  58  59  60 

Real-world evidence confirms high effectiveness of Pfizer-BioNTech COVID-19 vaccine and profound public health impact of vaccination one year after pandemic declared