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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background/Objectives: The SARS-CoV-2 pandemic challenged patients with inflammatory bowel disease (IBD) under immunosuppressive therapies. We used data from the RisCoin cohort to investigate factors associated with a poor immune response to mRNA vaccination in these patients. Methods: From 4115 RisCoin participants, we matched 110 IBD patients by age and time interval since the second mRNA vaccination with 306 healthcare workers (HCW) without comorbidities (HCW-healthy) and 292 with medical conditions (HCW-plus); all were SARS-CoV-2 infection naïve. Basic questionnaires collected data on medication, COVID-19 vaccinations and side-effects, dietary patterns, lifestyle factors, and self-perceived stress. Main outcomes included anti-spike immunoglobulin levels and antibody-mediated live-virus neutralization immunity (NT) to the Omicron BA.1 variant (threshold NT ≥ 10 defined as IC50 values ≥1:10 serum dilution) after the second (baseline) and third vaccinations. Results: At baseline, IBD patients treated with anti-TNF but not those under vedolizumab or ustekinumab therapy had lower anti-spike levels compared to HCW-healthy and HCW-plus (166 versus 1384 and 1258 BAU/mL, respectively; p < 0.0001). Anti-TNF compared to vedolizumab/ustekinumab-treated patients reached NT titers above threshold in 17% versus 64%, respectively, and HCW-subgroups in 73% and 79% (all p < 0.0001). Current smokers showed a four to five times increased risk for non-neutralizing immunity compared to non-smokers. After the third vaccination, NT titers did not reach threshold in 15% anti-TNF compared to 5% vedolizumab/ustekinumab-treated patients and none of HCW (p < 0.01). Patients with IBD reported fewer clinical symptoms after vaccination. Perceived stress was not increased. Conclusions: Our findings support individualized schedules for mRNA-based vaccines in IBD patients with different immunosuppressive therapies and enforcement of non-smoking.

Details

Title
Factors Associated with Impaired Humoral Immune Response to mRNA Vaccines in Patients with Inflammatory Bowel Disease: A Matched-Cohort Analysis from the RisCoin Study
Author
Csollarova Katarina 1 ; Koletzko Leandra 2 ; Le Thi Thu Giang 3   VIAFID ORCID Logo  ; Wratil, Paul R 4   VIAFID ORCID Logo  ; Zhelyazkova Ana 5   VIAFID ORCID Logo  ; Breiteneicher Simone 2 ; Stern, Marcel 6   VIAFID ORCID Logo  ; Lupoli Gaia 6 ; Schwerd Tobias 1 ; Choukér Alexander 7   VIAFID ORCID Logo  ; Hornung Veit 8   VIAFID ORCID Logo  ; Keppler, Oliver T 4 ; Adorjan Kristina 9   VIAFID ORCID Logo  ; Török, Helga Paula 2 ; Koletzko Sibylle 10   VIAFID ORCID Logo 

 Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany 
 Department of Medicine II, LMU University Hospital Munich, 81377 Munich, Germany 
 Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany, Stiftung Kindergesundheit, c/o Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany 
 Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU Munich, 80336 Munich, Germany, German Center for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany 
 Institut für Notfallmedizin und Medizinmanagement (INM), LMU Klinikum, LMU Munich, 80336 Munich, Germany 
 Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU Munich, 80336 Munich, Germany 
 Laboratory of Translational Research Stress and Immunity, Department of Anesthesiology, LMU University Hospital, LMU Munich, 81377 Munich, Germany 
 Gene Center and Department of Biochemistry, LMU Munich, 81377 Munich, Germany; [email protected] 
 Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 80336 Munich, Germany, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland 
10  Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany, Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum, University of Warmia and Mazury, 10-561 Olsztyn, Poland 
First page
673
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
2076393X
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3233262593
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.