Postvaccination Symptoms After a Fourth Dose of mRNA SARS-CoV-2 Vaccination in Patients With Inflammatory Bowel Disease

As immune protection against coronavirus disease 2019 (COVID-19) infection following booster doses wanes and as new variants emerge, a fourth dose of COVID-19 mRNA vaccine is recommended for individuals at high risk of more severe disease including the immunocompromised population and those with inflammatory bowel disease (IBD) on immunotherapies.1 A fourth mRNA vaccine dose against SARS-CoV-2 is well tolerated in healthy individuals.2 Previous studies showed that adverse effects after mRNA SARS-COV-2 vaccination are commonly experienced after the first and second doses but are less common following a third jab in patients with IBD.3,4 However, little is known about symptoms following a fourth dose among this population. The objective of this study was to investigate the frequency and severity of symptoms following a fourth mRNA vaccine dose in IBD patients. This is a prospective, multicenter, observational study conducted with patients referred from 26 gastroenterology practices across the United States. Postvaccination symptoms after 4 mRNA SARS-CoV-2 vaccine doses in IBD patients were evaluated. Participants with IBD aged 13 years and older who had at least 1 dose of mRNA vaccine were included. We used an electronic survey administered by through the Coronavirus Risk Associations and Longitudinal Evaluation in IBD (CORALE-IBD) prospective vaccine registry to collect data.5