Latest: Coronavirus vaccine for people with Crohn’s or Colitis

17 December 2021

The COVID-19 vaccine is low risk, and is the best way to protect yourself and others against coronavirus. It's important to consider getting the vaccine and boosters when offered to you, especially if you are at increased risk of complications from the virus.

Read more general COVID-19 information including latest updates on our Coronavirus Hub page.

Visit the NHS website for general information about the vaccine and how it will be delivered. Our information is specific to Crohn's and Colitis - if you have other health conditions or feel there is another reason why the vaccine may not be right for you, speak to your healthcare professional.


I will take the vaccine and I will strongly encourage all my patients [with Crohn's or Colitis] to take the vaccine.

There is lots of information on the Crohn's & Colitis UK website. We will be there to fight your corner right through this for you.

Professor Shaji Sebastian
Consultant Specialist in IBD/Gastroenterology

Can people with Crohn's or Colitis have the COVID-19 vaccine?

Having Crohn's or Colitis, or taking any medicine to treat your condition, will not stop you from being able to have the COVID-19 vaccine. All of the available vaccines are suitable for people taking biologics, steroids or immunosuppressants, as well as people who have a stoma or J-pouch. 

As with any medicine or vaccine, there is a small risk of side effects, which you can find out more about on the NHS website. There is no evidence to suggest that having Crohn's or Colitis, or taking any medicine to treat your condition, increases your risk of side effects. When weighing up the risk of side effects of the vaccine, it's also important to also consider the risks of complications from COVID-19 if you were to catch the virus.

If you feel you have had a side effect from the COVID-19 vaccine, you can report it via the MHRA Yellow Card reporting site.

As is the case with other vaccines, no coronavirus vaccine will be 100% effective for everyone, and there is no guarantee that it will give complete protection. To compare, flu jabs are around 50% effective on average for the general population, yet are still effective in reducing the amount of hospitalisations and serious complications from flu. If you do catch COVID-19 after being vaccinated, it is likely that the virus will be less severe and you will recover faster than if you had not had the vaccine. 

Find out more about coronavirus research in people with Crohn's and Colitis.

New variants
It's not a surprise that new variants of the coronavirus have developed. As viruses spread, they mutate. There are now a number of different coronavirus variants in the UK and it is not clear if the vaccines will give protection from them all. 

No vaccine is ever 100% effective. Having your coronavirus vaccine doses when you're invited will still offer you the best protection possible against the different coronavirus variants in the UK.

Read our Blog I've received the coronavirus vaccine by Heather, living with Crohn's.


Can immunosuppressed people have the vaccine?

Being on an immunosuppressant medicine for your Crohn's or Colitis does not mean that you don't have an immune system.
Being on certain immunosuppressant medicines may make the vaccine less effective. Your immune system is still able to fight off infections, just not quite as well as other people. Therefore you are still able to have vaccines that are not 'live' vaccines, no matter what medicine you take for your Crohn's or Colitis. None of the COVID-19 vaccines are classed as live - including the AstraZeneca vaccine, as it has been altered so that it can't replicate.

If you were taking immunosuppressants around the time of your first two vaccines you may be eligible for a third dose.

Crohn's & Colitis UK are supporting the research study CLARITY, which is looking at antibodies in people on infliximab and vedolizumab. The study found that people on infliximab produced fewer antibodies after one vaccine, but most people produced a good number of antibodies after the second vaccine. Read the full results on CLARITY.

This does not mean you should stop your treatment. Stopping treatment can lead to a flare of your Crohn's or Colitis, which puts you at greater risk from serious complications of COVID-19. Even if the COVID-19 vaccine works slightly less well for you, it will still offer greater protection than not having the vaccine.

I would recommend everyone with Crohn's or Colitis to have the coronavirus vaccine as I recently had mine. I feel it is important especially for those who are immunosuppressed – we are all here to fight it together with the support and guidance from Crohn's & Colitis UK, who can provide you with more advice and information.

Daljit Chohan
IBD Specialist Nurse

What is the third vaccine dose for people with a weakened immune system?

The Joint Committee on Vaccinations and Immunisation (JCVI) has recommended that people aged 12 years and over who were immunosuppressed (have a weakened immune system) at the time of their first and second COVID vaccines (primary vaccination) should receive a third dose of COVID-19 vaccine. This will be followed by a booster (fourth) dose from three months (91 days) after your third dose.

This is because this group of people may not have made a good response to the first two doses of vaccine. If you are in this group, the third dose will increase your chances of making an immune response. This will help protect you from serious COVID-19 infection.

For more information about who is eligible for the third vaccine dose see our news article.


COVID-19 booster vaccine

A booster vaccine is another dose of vaccine to keep immune response to COVID-19 high. It should be given at least three months after your second dose (or third dose if you have a weakened immune system) of vaccine.

For more information about the booster vaccine, including who is eligible and which vaccine you will get, see the page for your nation:

EnglandNHS information on the booster dose of the coronavirus (COVID-19) vaccine

Northern Ireland: NI Direct COVID-19 Booster Vaccination

Wales: Welsh Government COVID-19 Booster Vaccination 

Scotland: NHS Inform Scotland COVID-19 Booster Vaccination

Is the booster different to the third vaccine dose for people who are severely immunosuppressed?

Separate to this booster programme, the NHS is offering a third vaccine dose to people aged 12 and over who are severely immunosuppressed and may not have made an immune response to the first two doses. For more information, visit our news article on the third vaccine dose. If you've had the third dose for people with a severely weakened immune system, you'll be eligible for a booster (fourth) dose from three months (91 days) after your third dose. 

Will I get my flu jab at the same time?

The COVID booster vaccine and annual flu vaccination could be given at the same appointment. In some cases, they may be given separately for practical reasons. It is important to get your flu jab if you are offered one.


How to book your vaccine

England
You can book a slot via your GP, on the NHS booking siteor by calling 119. 

Wales
See the advice for your local health board.

Scotland
Contact your health board.

Northern Ireland
Book online through the COVID-19 Vaccine Service for NI or call 0300 200 7813. 


Which coronavirus vaccine will I be offered?

The COVID-19 vaccines currently approved for use in the UK are:

  • Moderna vaccine
  • Oxford/AstraZeneca vaccine
  • Pfizer/BioNTech vaccine
  • Janssen vaccine

All of the available coronavirus vaccines are considered suitable for people with Crohn's or Colitis, as they are not live vaccines. Having Crohn's or Colitis, or taking medicine to treat your condition, will not affect which coronavirus vaccine is best for you. 


AstraZeneca vaccine in people under 40

The JCVI has advised that it is preferable for people under 40 to have a vaccine other than AstraZeneca. This is due to a possible, very rare, risk of blood clots  The risk of blood clots is extremely rare – just over 10 people develop this condition for every million doses of AstraZeneca vaccine given. 

If you have concerns or are unsure about whether to have the AstraZeneca vaccine, contact your medical team for advice. When weighing up the risks and benefits, you should also consider that clotting problems are a common complication of COVID-19 infection. Deep vein thrombosis (DVT), or clotting in the legs, occurs in 11.2% of people who have COVID-19. Pulmonary embolism, or clotting on the lungs, occurs in 7.8% of people who have COVID-19.

Read more about the COVID-19 vaccination and blood clotting on the gov.uk website.

Not everyone with Crohn's or Colitis is at higher risk of severe illness from coronavirus - check your risk.

Does my Crohn's or Colitis increase my risk of blood clots?
Crohn's and Colitis are not blood clotting disorders. However, they may slightly increase your risk of blood clots. You're more at risk during a flare-up or if you're confined to bed, for example in hospital. You can reduce your risk by not smoking, keeping active, drinking plenty of fluids, and wearing support stockings. 

The risk of blood clots in Crohn's and Colitis should not stop you from having the AstraZeneca vaccine. This is because the blood clots after the vaccine appear to have happened randomly, and no risk factors have been identified. However you may wish to seek advice from your medical team if you have a history of thrombosis, are pregnant, or are taking the medicine tofacitinib


Has the vaccine been tested in people with Crohn's or Colitis?

Many people with Crohn's and Colitis have now safely had the COVID-19 vaccine in the UK. We spoke to our supporters Heather, Carl and Donna about their experiences. 

The CLARITY trial is looking at antibody responses after coronavirus vaccination in people taking infliximab and vedolizumab - and in people taking these medicines in combination with an immunomodulator (such as azathioprine or methotrexate). Find out what this research has found so far.

The coronavirus vaccine has been extensively tested, and trials have involved people with varied chronic underlying conditions and broad age ranges, including many older people. The data on how people with Crohn's and Colitis have coped with coronavirus and vaccines, even those taking medicines that affect their immune system, is reassuring, and shows no significant differences from the general population.

All the data we have from other vaccines shows us that people with Crohn's and Colitis are not at any increased risk of side effects. Delaying your vaccine could lead to you having worse complications if you catch coronavirus. 

Every medicine that IBD patients take outside of their usual IBD medicines - for example paracetamol for your headache, or insulin for diabetes, blood pressure medicines - none of those medicines have been tested specifically in clinical trials of IBD patients. But this doesn't mean that these medicines are risky for IBD patients. It's the same for all other vaccines that we use in routine practice, they were never tested in IBD patients prior to their approval for the general population. Accordingly, we should consider these new vaccines low risk in IBD patients.

We will of course continue to monitor how these vaccines perform as they are rolled out. Balancing risk is an important consideration for all medicines. The one thing we know for certain is that coronavirus infection itself is definitely high risk, and can cause serious problems and even death in some patients. 

Dr Nick Powell
Clinical Reader and Consultant in Gastroenterology

Will the vaccine cause my Crohn's or Colitis to flare?

We are aware of some people with Crohn’s or Colitis reporting that they had a flare up after getting the COVID-19 vaccine. At this stage, there is no evidence that the vaccines can cause a flare up of Crohn’s or Colitis or make an existing flare worse. We are observing the data very closely and will update our information accordingly.

Some common side effects of the vaccine include feeling sick (nausea), fatigue, vomiting and diarrhoea. It may be that if you are experiencing these, it is a temporary side effect rather than the start of a Crohn's or Colitis flare-up.

If you feel you have had a side effect from the COVID-19 vaccine, you can report it via the MHRA Yellow Card reporting site, and speak to your IBD Team.

In their official statement on the coronavirus vaccine the British Society of Gastroenterology (BSG) states:

“No serious gastrointestinal side-effects to SARS-CoV2 vaccinations have yet been reported. Furthermore, data from other commonly employed vaccination programs are reassuring, with no serious gastroenterological side effects and low rates of increased IBD disease activity reported.”

 

If you look at the history of vaccinations in people with immune problems like Crohn's and Colitis, there has been no evidence that commonly used vaccinations trigger a flare in your disease.

The COVID-19 vaccine particles are unlikely to live in your body forever. Your body will probably eliminate the particles in about ten days [from what we have seen from mice studies] and then it's gone forever. You generate an immune response against them. Your immune system is smart and has an excellent memory. It will remember the viral components present in the vaccine, and if it ever sees the coronavirus itself in the future, it will recall the encounter and rapidly generate antibodies that neutralize the virus, or protective immune cells called T-cells.

Your immune system is also highly specific. The immune cells triggered to generate a response to the coronavirus vaccine, are completely different to the immune cells likely to be involved in damaging the gut IBD. Therefore, it is unlikely that immune activation stimulated by the vaccine would be misdirected and make your IBD worse. We certainly haven't seen this happen with any other the other commonly used vaccines.

Dr Nick Powell
Clinical Reader and Consultant in Gastroenterology

When weighing up the risk of side effects of the vaccine, it's also important to also consider the risks of complications from COVID-19 if you were to catch the virus. Complications from the virus can be life-threatening, especially if you are at increased risk. Research has shown the vaccines help reduce your risk of getting seriously ill or dying from COVID-19.

My experience with coronavirus felt no different to when I have a bad flare up. It started with abdominal pain, nausea, aching followed by a fever and high output from my stoma. I was also very fatigued throughout this and it continued for seven days. On day 6, I was admitted for to hospital and placed on IV antibiotics and fluids.

Emma
Living with Colitis

Should I take (or avoid taking) the vaccine at certain times?

Both the JCVI and the British Society of Gastroenterology (BSG) recommend that, if possible, you should have your vaccine when your immune system is at its strongest. However, NHS England has also pointed out that for some people who are on 'regular, long term immunosuppressive therapy, or where the degree of immunosuppression is relatively constant' that timing your dose around your injections or infusions is likely to be less important. 

If you are currently going through a treatment cycle or about to move to a different or higher dose medication that would make you more immunosuppressed, your IBD team should advise you about the best timing for your vaccine doses. This is recommended because the vaccine may be less effective once you are more immunosuppressed.

If you are in a flare it is best to speak to your IBD team about when to have your vaccine doses. The vaccines are safe to have during a flare, but some medicines you might take during a flare can affect how well the vaccine works. 

There are some times when you might need to delay either your vaccine or medicine. These are:

  • If you feel very unwell on the day of your appointment (for example if you have a high fever or symptoms of coronavirus), your vaccine may be postponed until you have fully recovered.
  • If you're scheduled to have the shingles vaccine. You should ideally wait 7 days between the coronavirus vaccine and the shingles vaccination as it is a live vaccine and may react with the COVID-19 vaccine. This does not apply to other vaccines, such as the flu jab.
  • If you're taking steroids. Your IBD Team may recommend that you've tapered down to a lower dose, or have finished your course of steroids, before you have the COVID-19 vaccine. This is because the vaccine will be more effective if you are not taking a higher dose of steroids. However, it is still safe to take the vaccine while on steroids.
  • If you're already taking a biologic or immunosuppressant medicine, or just about to start a new biologic or immunosuppressant.  Speak to your IBD team about the best time to have your vaccine doses. The vaccine may be less effective once you start a biologic or immunosuppressant. However, it is still safe to take the vaccine while on these medicines.

If you have Crohn's or Colitis it's better to be protected from flu as soon as possible, so if you are eligible for a flu jab and haven’t yet had it this winter, contact your GP or community pharmacy.


Can children and young people have the vaccine?

The JCVI (Joint Committee on Vaccination and Immunisation) are a group of experts that advise the government on vaccines. This group, along with Chief Medical Officers, have been looking at the benefits and effects of young people receiving the vaccine.

In England, Wales, Northern Ireland and Scotland, all children aged 12 to 15 years will be offered the Pfizer COVID-19 vaccine.  The vaccine is not mandatory and parents or guardians will be asked to give consent before their child receives the vaccine.

In England, the vaccine is likely to be given as part of the school vaccination programme. For more information, visit the GOV.UK website. For young adults aged 16 to 18 years, they can attend a walk in centre for their vaccination.

In Scotland, all children and young people aged 12 to 17 years should receive an appointment letter inviting them to an appointment at a drop-in centre or vaccination clinic. For more information, visit the NHS Inform Scotland website.

In Wales, some areas will invite this age group to vaccination centres and other areas will offer the vaccine through the school vaccination programme. For more information, visit the Welsh Government website.

In Northern Ireland, the vaccine is likely to be given as part of the school vaccination programme. For more information, visit the Northern Ireland Department of Health website. Young people aged 16 to 18 years can book an appointment or find a mobile clinic here.

In all four nations, children in the 12-15 years age group with health conditions and those living with clinically vulnerable people should have already been contacted about how to get their vaccine. 


Is it safe to have the vaccine if I'm pregnant or planning to become pregnant?

You and your developing baby cannot catch COVID-19 from having the vaccine. This is because the coronavirus vaccine is a non-live vaccine. This means the virus cannot grow in your body and cause an infection. Other non-live vaccines are already routinely offered during pregnancy. These include the whooping cough and flu vaccines. There have been no proven risks or long-term effects to the mother or baby from these vaccines. There is also no evidence to suggest the coronavirus vaccine would affect female or male fertility. 

You can have the COVID-19 vaccine if:

  • you're pregnant or think you might be
  • you're breastfeeding
  • you're trying for a baby or might get pregnant in the future

The NHS has more information on Pregnancy, breastfeeding, fertility and COVID-19 vaccination.

To help you make the right decision for you, the RCOG have made a helpful guide for pregnant women. 


Can I have the vaccine if I've had an allergic reaction before?

In most cases, yes. If you've had an allergic reaction before, including a reaction to a medicine you take for your Crohn's or Colitis, you will usually still be able to have any of the available COVID-19 vaccines.

The exceptions to this are:

  • You have an allergy to any of the vaccine ingredients.
  • You've had a very severe form of allergic reaction called anaphylaxis to many different medicines.
  • You've had an anaphylactic reaction where your doctors couldn't explain why it happened.

If you have, then it is recommended that you do not have the Pfizer vaccine. You will still be able to have the Oxford/AstraZeneca vaccine. Anaphylaxis is a severe and potentially life-threatening reaction which usually develops suddenly and gets worse very quickly. Anaphylactic reactions are not common - if you have had an allergic reaction before, it is unlikely to have been anaphylaxis. You can ask your healthcare professional for advice when it is your turn to have the vaccine.


 Can I have an antibody test after my vaccine?

Antibody testing for coronavirus is not yet widely available for free on the NHS. This is because antibody tests currently cannot give a clear indication of how well you are protected from COVID-19.   

The British Society of Gastroenterology (BSG) have stated that antibody testing is not currently recommended in routine clinical practice. Read the BSG position statement here.

Antibodies are proteins made by your body to fight infection. An antibody test is a blood test that looks at antibodies to coronavirus. The test result may tell you your level of antibodies, or just a positive or negative result.  

An antibody test can help to see if you have been exposed to the virus before – whether that is from infection or a vaccination. However, it cannot tell you your overall level of immunity.   

This is for a few reasons. 

  • The body has many ways of fighting infection. For example, T cells have also been shown to be crucial in fighting coronavirus. However, T cells are much harder to test. An antibody test will not show your T cell response. 
  • There are lots of different types of antibodies that your body can produce, and an antibody test will not test them all. Even if it did, it cannot tell you how good quality these antibodies are, only the level in your blood. It is not clear yet whether high levels of antibodies equal high levels of protection from the virus.  
  • It’s not known how long antibodies stay in your body. People who produce antibodies may still be vulnerable to coronavirus later.  
  • You may get a negative result even if you do have antibodies in your blood. This may be because the level of antibodies is too low to be detected by the blood test, even though it is still high enough to be helpful in fighting infection.  

Another issue with antibody testing is that it may give people a false sense of security if their antibody levels are high. Or on the other hand, the test could make people think they are extremely high risk if the result is negative or very low, even if they actually have a good immune defence.   

There are a few groups that can get antibody tests for free.   

  • Those that are taking part in certain COVID-19 studies may be able to have antibody tests.  
  • Certain occupations can also make you eligible for antibody testing. See government advice for more information.

These results will not be able to tell you the likelihood of getting the virus in the future.  


Are the needs of people with Crohn's and Colitis being considered?

Many people with Crohn's and Colitis are at increased risk of complications from coronavirus - we're fighting to make sure that those most at risk are protected.

We've written to the JCVI, who advise UK health departments on immunisation, asking them to ensure that people with Crohn's or Colitis in both the moderate and high risk groups would be eligible for priority COVID-19 vaccination. We have also written to the relevant Ministers in all four UK nations and the Chief Medical Officers with the same ask. Find out more about how we're speaking up for you.

More coronavirus support and information