患有炎症性肠病 (IBD) 的儿童对严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 疫苗接种的血清学反应可能会减弱，并且随后感染 2019 年严重冠状病毒病 (COVID-19) 的风险会增加。我们试图描述疫苗接种后发生 SARS-CoV-2 感染的患者的结果，描述疫苗接种后 1 年的 SARS-CoV-2 抗体特征，并确定与持久血清学反应相关的因素。我们招募了接受 ≥ 2 剂疫苗的 IBD 儿童SARS-CoV-2 疫苗的研究，并前瞻性收集了以下方面的数据：(1) 人口统计、IBD 特征和治疗；(2) SARS-CoV-2 疫苗接种、检测和感染症状。在第 12 周和第 52 周进行两部分免疫后，获得血清用于测量抗受体结合域 IgG 抗体。我们招募了 298 名参与者（平均年龄 11.9± 3.82，50% 为女性，67% 患有克罗恩病）。一半的参与者在接种疫苗后出现有症状的 COVID-19 感染，但只有 2 人 (1%) 需要住院治疗。抗肿瘤坏死因子 α (TNF-α) 与有症状的 COVID-19 感染的可能性较高相关，调整后的风险比为 2.7（95% CI，1.5-5.0；P = .001）。几乎所有参与者 (99%) 在第 52 周时均检测到抗体。与年龄较大的儿童相比，1-5 岁儿童的 52 周抗体水平较低 (P = .04)，接受抗 TNF-α 治疗的儿童也是如此 (P = .007) 以及在第 52 周之前仅接受 2 剂疫苗的患者 (P < .001)。尽管使用了降低年幼儿童的疫苗剂量和广泛的免疫抑制疗法。© 作者 2024。由牛津大学出版社代表克罗恩病出版

Children with inflammatory bowel disease (IBD) may have diminished serologic response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and increased risk for subsequent severe coronavirus disease 2019 (COVID-19) infection. We sought to describe outcomes among those who developed SARS-CoV-2 infection following vaccination, characterize SARS-CoV-2 antibodies 1 year post-vaccination, and identify factors associated with durable serologic response.We recruited children with IBD who received ≥2 doses of SARS-CoV-2 vaccine and prospectively collected data on (1) demographics, IBD characteristics, and therapy and (2) SARS-CoV-2 vaccination, testing, and infection symptoms. Serum was obtained for measurement of anti-receptor-binding domain IgG antibodies following a 2-part immunization at 12 and 52 weeks.We enrolled 298 participants (mean age 11.9 ± 3.82, 50% female, 67% Crohn's disease). Symptomatic COVID-19 infection after vaccination occurred in half of the participants, although only 2 (1%) required hospitalization. Anti-tumor necrosis factor alpha (TNF-α) was associated with higher likelihood of symptomatic COVID-19 infection, with an adjusted hazard ratio of 2.7 (95% CI, 1.5-5.0; P = .001). Nearly all participants (99%) had detectable antibody at Week 52. Children aged 1-5 years had lower 52-week antibody level compared to older children (P = .04), as did those on anti-TNF-α therapy (P = .007) and those who received only 2 vaccine doses prior to Week 52 (P < .001).SARS-CoV-2 vaccination provides lasting serologic response and protection against severe COVID-19 for most children with IBD, despite the use of lower vaccine doses in younger children and wide-ranging classes of immunosuppressive therapies.© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.