COVID-19 vaccinations are safe and effective for people with ulcerative colitis (UC). Without vaccination, a person with UC may have a higher risk of severe illness from COVID-19 due to immunosuppressants. People can discuss their prescribed medications and possible risks with a doctor.
UC is a form of inflammatory bowel disease (IBD) that causes inflammation in the colon.
Experts consider UC an autoimmune disease, where a person’s immune system mistakenly attacks healthy body cells and tissue. The condition means that someone’s immune system attacks the colon and rectum, causing:
- inflammation
- pain
- bleeding
COVID-19 is a disease that comes from a virus known as SARS-CoV-2.
Scientists have developed vaccinations for COVID-19 to offer protection against the disease. These vaccines trigger an immune response in the body to build a defense against the virus.
As UC is an autoimmune disease, people may have concerns about the possible links between receiving a vaccine and the effect on a person’s disease activity.
This article looks at how safe COVID-19 vaccinations are for people with UC, the possible side effects, and how COVID-19 may affect someone with UC.
Vaccinations for COVID-19 work by triggering an immune response in the body that helps create a defense against the infection.
Currently, there are
- mRNA vaccines, including Pfizer-BioNTech or Moderna
- protein subunit vaccines, including Novavax
- vector vaccines, including Johnson & Johnson’s Janssen
As the vaccination process involves the immune system, and UC is an autoimmune condition, some people may have concerns about whether it is safe for them and if it may cause a flare-up.
In addition, treatments for UC involve controlling a person’s overactive immune system with medication that aims to suppress it. These medications can include:
- tumor necrosis factor (TNF) alpha antagonists
- immunomodulators
- corticosteroids
Since these treatments suppress the body’s immune system response, there may be concerns over whether they will result in a less effective vaccination response.
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However, the Crohns & Colitis Foundation recommends people with UC get a COVID-19 vaccination if they are eligible. Over the past few years, research has concluded that those with UC respond to these vaccinations similarly to the general population.
A 2021 study investigated the response that people with IBD had to COVID-19 vaccinations. Many of the people were on anti-TNF biologic medications. The study found that despite a person’s condition and medications, vaccinations mounted an effective immune response.
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Possible risks
The general trend strongly suggests that COVID-19 vaccinations are safe and effective for people with UC. However, a 2021 case study described a person with an acute flare of their condition after receiving their vaccination.
The authors state that although nonlive vaccinations are safe for people with UC, the vaccine could have induced stress that may have triggered a flare.
Most evidence concludes that the risk of a flare is low. However, if a person notices their UC symptoms worsening after the COVID-19 vaccination, they can consult a medical professional.
Side effects typically last no longer than a few days, and a person can manage them by:
- resting
- staying hydrated
- taking medication to manage their fever or pain
Although these side effects may cause discomfort, they generally signify that the body is responding to the vaccination and building a defense.
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- pain at the site of injection
- fever
- fatigue
- muscle aches
- headache
- diarrhea
Reactions to the vaccination seem similar between people with and without UC. However, a 2021 study found that those with the condition may experience more gastrointestinal (GI) side effects, including abdominal pain and diarrhea.
In severe cases, if a person experiences any of the below symptoms, they should seek immediate medical attention:
- trouble breathing
- chest pain
- loss of speech or mobility
A person with UC may experience the same symptoms of COVID-19 as the general population.
These symptoms can
- fever or chills
- shortness of breath
- fatigue
- headache
- loss of taste or smell
- diarrhea
- nausea or vomiting
- sore throat
- congested or runny nose
If a person experiences any of the above or other symptoms, they can discuss them with a doctor to determine the possible causes and remedies.
Possible trigger of IBD flares
A 2021 paper found that people with IBD experiencing an active SARS-CoV-2 infection tended to have GI symptoms, such as diarrhea, more frequently than the general population.
The research also demonstrated that although experiencing more GI symptoms made hospitalization more likely, it did not increase the chance of COVID-19 becoming fatal.
However, there may be a possible link between the medications for UC, such as corticosteroids and 5-aminosalicylic acid, with more severe symptoms of the infection.
The interactions between COVID-19 and UC are complex. Research shows that a person with UC is likely to have a similar disease response to the general population. However, a person with UC should follow their doctor’s advice if they become unwell with COVID-19.
Medical professionals may sometimes recommend a temporary change to medications and their dosages if they develop COVID-19.
A person with UC should not change their medication and treatment plan without consulting a medical professional.
Some people with UC have concerns about how COVID-19 vaccination may affect them and their symptoms. However, recent research suggests that these vaccinations are typically safe and effective for those with the condition.
A person can consult their doctor about how their treatments may interact with COVID-19 vaccinations and the best steps to take if they become unwell with COVID-19.