The following is a summary of “Postvaccination Immunogenicity of BNT162b2 SARS-CoV-2 Vaccine and Its Predictors in Pediatric Inflammatory Bowel Disease,” published in the February 2023 issue of Pediatric Gastrology and Nutrition by Bronsky, et al.
When pediatric patients with inflammatory bowel disease (IBD) over 12 received the messenger ribonucleic acid BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, researchers prospectively compared their postvaccination immunity to that of healthy controls and searched for indicators of its robustness.
Microblot array was used to measure the levels of the anti-receptor binding domain, anti-spike S2, anti-nucleocapsid, anti-IgG, and anti-IgA antibodies in 139 pediatric IBD patients [65 fully vaccinated (2 doses), median age 16.3, interquartile range (IQR) 15.2-17.8 years, median time from vaccination (IQR) 61.0 (42.0-80.0) days], and 1,744 controls (46, 37-57years) using microblot array.
Anti-receptor binding domain IgG antibodies with similar titers were produced in all IBD and control patients. Patients with IBD had a greater percentage of observations with positive anti-spike S2 IgG than controls (63% vs. 21%, odds ratio 2.99 (1.51-5.90)), and their titers were also higher [median (IQR) 485 (92–922) vs. 79 [33–180] IU/mL]. The presence of IBD was correlated with the anti-receptor binding domain and anti-spike S2 IgG levels. They discovered relationships between anti-spike S2 IgG levels and time since vaccination (β −4.85, 95% CI −7.14 to 2.71, P = 0.0001), past SARS-CoV-2 polymerase chain reaction positivity (206.76, 95% CI 39.93-374.05, P = 0.0213), and anti-tumor necrosis factor medication (−239.68, 95% CI −396.44–83.55, P = 0.0047). 43% of patients reported vaccination side effects (mostly mild). 46% of observations with positive anti-nucleocapsid IgG had a history of SARS-CoV-2 infection.
Compared to controls, patients with IBD developed more postvaccination anti-spike S2 antibodies. In addition, post-vaccination antibody production was higher after prior SARS-CoV-2 infection and lower after anti-tumor necrosis factor therapy.