Abstract

Background: Patients with inflammatory bowel disease (IBD) have a high risk for infection. Pneumonia related to influenza and pneumococcal infection is one of the most common infection-related complications in IBD. Aims: To evaluate the immunogenicity of pneumococcal and influenza vaccination in patients with IBD receiving different treatments. Methods: We searched four databases for studies evaluating seroprotection and seroconversion rates after influenza or pneumococcal vaccination in IBD on 20th October 2020. In the meta-analysis, odds ratios (OR) were calculated with 95% confidence intervals (CI). Results: We included twelve studies (1429 patients with IBD) in this meta-analysis. The seroconversion rate after pneumococcal vaccination and the seroprotection rate after influenza vaccination were not significantly lower in patients receiving conventional immunosuppressive treatment compared to the non-immunosuppressed patients. Meanwhile, the seroconversion rate following pneumococcal vaccine was significantly lower in patients with anti-TNF mono- or combination therapy (OR = 0.28, CI: 0.15–0.53, and OR = 0.27, CI: 0.15–0.49, respectively). In the analysis of patients with IBD on conventional immunosuppressive monotherapy versus anti-TNF therapy, the seroprotection rate after influenza immunization did not differ between patients receiving either anti-TNF mono-or combination therapy (OR = 1.45, CI: 0.62–3.38 and OR = 0.91, CI: 0.37–2.22, respectively). Conclusion: Our data suggest that the immunization against Pneumococcus and influenza is safe and immunogenic despite immunosuppression.

  • Adults (18+)
  • Elderly (65+)
  • Efficacy/effectiveness
  • Safety
  • Pneumococcal disease
  • Influenza