Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis

INTRODUCTION: Risk of adverse effects and flare of inflammatory bowel disease (IBD) are frequently cited reasons for COVID-19 vaccine hesitancy. METHODS: Electronic databases were searched to identify studies reporting the use of COVID-19 vaccine in IBD. We selected studies reporting the incidence of various adverse effects (local or systemic) and flares of IBD after COVID-19 vaccination. The pooled incidence rates for various adverse effects, stratified for the dose and the type of vaccine (adenoviral or mRNA) were estimated. RESULTS: Nine studies (16 vaccination cohorts) were included. The pooled incidence rate of overall adverse events was 0.55 (95%CI, 0.45–0.64, I(2)= 95%). The pooled incidence rate of local adverse events was 0.64 (0.47–0.78, I(2)= 100%). The pooled incidence rates of fatigue, headache, myalgia, fever and chills were 0.30 (0.21–0.40, I(2)= 99%), 0.23 (0.17–0.30, I(2)= 99%), 0.18 (0.13–0.24, I(2)= 99%), 0.10 (0.06–0.17, I(2)= 98%) and 0.15 (0.06–0.3, I(2)= 86%), respectively. The pooled incidence rates of severe adverse events, adverse events requiring hospitalization and flares of IBD following COVID-19 vaccination were 0.02 (0.00–0.12, I(2)= 97%), 0.00 (0.00–0.01, I(2)= 27%) and 0.01 (0.01–0.03, I(2)= 45%), respectively. CONCLUSION: COVID-19 vaccination in patients with IBD appears to be safe with only mild adverse events. Flares of IBD and severe adverse events requiring hospitalization were infrequent.