SARS-CoV2 Vaccination immunogenicity
in Immunosuppressed inflammatory bowel disease Patients
FAQS
Q. WHAT IS THE DIFFERENCE BETWEEN A 3RD PRIMARY DOSE VACCINE AND A BOOSTER?
VIP response:
A 3rd primary dose is offered to individuals who may not have mounted a full immune response to 2 doses of COVID-19 vaccine because they are immunosuppressed due to an underlying health condition or drug treatment. For those aged 18 years and over, the JCVI advises a preference for mRNA vaccines Pfizer or Moderna. For those aged 12 to 17 years the Pfizer-BNT162b2 vaccine remains the preferred choice. The third primary dose should be given at least 8 weeks after the second dose.
In contrast booster doses are given to maintain protection against COVID-19 disease as this wanes over time. The JCVI advises a preference for the Pfizer vaccine to be offered as the third booster dose irrespective of which vaccine was used for doses 1 and 2. Alternatively, individuals may be offered a half dose of the Moderna vaccine. Currently booster vaccines are only offered to:
those living in residential care homes for older adults
all adults aged 50 years or over
frontline health and social care workers
all those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19 (but are not eligible for a 3rd primary dose), and adult carers
adult household contacts (aged 16 or over) of immunosuppressed individuals
The booster vaccine dose is offered no earlier than 6 months after completion of the primary vaccine course.
Further advice:
3rd primary doses: Joint Committee on Vaccination and Immunisation (JCVI) advice on third primary dose vaccination - GOV.UK (www.gov.uk)
Booster doses: JCVI statement regarding a COVID-19 booster vaccine programme for winter 2021 to 2022 - GOV.UK (www.gov.uk)
Q. IN THE VIP STUDY MY BLOOD WAS TAKEN FOR T- CELL WORK, WILL I BE ABLE TO HAVE ACCESS TO THESE RESULTS?
VIP response:
No, unfortunately we cannot release these results currently. This is because the T-cell responses which correlate with protection against SARS-CoV-2 infection, symptomatic disease and severe COVID-19 are not known. Therefore, we do not know what level of T-cell response means for an individual participant.
Q. COULD YOU TELL ME MY ACTUAL ANTIBODY LEVEL (RATHER THAN POSITIVE OR NEGATIVE) AND HOW THIS COMPARES TO OTHER PARTICIPANTS IN THE VIP COHORT?
VIP response:
We are currently discussing this. However, it is important to note that the precise antibody level which correlates with protection against SARS-CoV-2 infection, symptomatic disease and severe COVID-19 are not known
Q. IF I AM ON AN INJECTED BIOLOGIC DRUG (E.G. INFLIXIMAB, VEDOLIZUMAB OR USTEKINUMAB), SHOULD MY VACCINATION BE TIMED AROUND THE DATES OF MY BIOLOGIC INFUSION OR INJECTION?
Q. If I am on an injected biologic drug (e.g. infliximab, vedolizumab or ustekinumab), should my vaccination be timed around the dates of my biologic infusion or injection?
Q. I HAD UNDETECTABLE LEVELS OF ANTIBODIES AFTER MY SECOND VACCINE DOSE AND HAVE SINCE RECEIVED A 3RD DOSE. WHAT ANTIBODY RESPONSE DO YOU EXPECT AFTER A 3RD DOSE?
VIP response:
Data from a number of studies have shown that the majority of patients have a good antibody response after a 3rd vaccine dose, even if antibody levels were low or undetectable after 2 doses. However, the durability of antibody responses after 3 doses in not yet know. Importantly, recent data from the CLARITY IBD study has shown that almost all breakthrough SARS-CoV-2 infections after 2 doses of vaccination are mild, even in people with low antibody levels.
Q) SHOULD PATIENTS ON VEDOLIZUMAB RECEIVE A 3RD PRIMARY VACCINE DOSE?
VIP response:
Data from the CLARITY IBD study suggests that Vedolizumab does not have a major impact on antibody responses to COVID-19 vaccine. However, in line with the British Society of Gastroenterology guidelines, we recommend vedolizumab-treated patients are offered a 3rd dose. Your local IBD team will be identifying patients who are eligible and sharing this information with GP surgeries and local vaccination centres.
Q) SHOULD I INFORM THE VIP STUDY TEAM WHEN I HAVE BOOKED AND/OR RECEIVED MY THIRD/BOOSTER DOSE OF VACCINE?
VIP response:
Yes. Please contact the VIP team (rde-tr.VIPSTUDY@nhs.net) to inform us of your third vaccine dose date so that we can book your second study visit 5-6 weeks after the third dose. Your expenses payment of £40 will be payable when you attend for your second study visit.