Attitude of patients with IBD toward COVID-19 vaccine in Saudi Arabia

Introduction: Vaccination is the key strategy of Coronavirus disease 2019 (COVID-19) prevention. Newly developed COVID-19 vaccines have shown safety profiles comparable to other vaccines commonly used in patients with inflammatory bowel disease (IBD). In this study we aim to assess the attitude of patients with IBD toward COVID-19 vaccine and to identify the potential concerns that may hinder the vaccination program in Saudi Arabia. Aims & Methods: We conducted a cross-sectional study including 281 patients. We developed an anonymous survey using Google survey which was distributed through the social media platforms. The questionnaire aimed to assess demographics, disease characteristics, as well as motivations and concerns regarding COVID-19 vaccination. The primary outcome was to assess the attitude of patients with IBD toward the COVID-19 vaccine in Saudi Arabia. The secondary outcome was to identify the possible predictors of vaccine acceptance by using multivariable regression and calculation of adjusted odds ratios (aORs). This study was approved by the institutional review board of King Fahad Specialist Hospital in Dammam. Results: A total of 281 patients with IBD completed the survey with a response rate of 281/599 (47%). Among participants;168/281(59.8%) were male and 122/281(43.4%) were young in the (26-35) age group. Almost half are married, 139/281(49.5%) and more than half 180/281(64.1%) have a bachelor's degree. Majority of the patients were non-smokers 201/281(71.5%) and have no major comorbidities 236/281(84%). With regards to disease characteristics;200/281(71.2%) are diagnosed as Crohn's disease, 71/281(25.3%) as ulcerative colitis and 10/281 (3.6%) as IBD-unclassified. A considerable number of patients 123/281(43.8%) have long-standing disease (>10 years) and 187/281(66.5%) are on biologics. A total of 160/281(56.9%) patients are willing to and have received the influenza vaccine during the last three years. Regarding the current COVID-19 pandemic;41/281(14.6%) have tested positive for the virus at some point in the pandemic, 44/281(15.7%) have lost a family member or a close friend as a result of COVID-19 infection and 243/281(86.5%) denied major negative economic influence. Majority of the patients 191/281(68%) have received the COVID-19 vaccine at the time of survey distribution. The two top rated motivations to get vaccinated are self-protection against the virus and social responsibility 131/281(46.6%) and 94/281(33.5%) respectively. Among the remaining 90/281 (32%) who aren't vaccinated, the major concerns are;potential interference with IBD medications 30/90 (33.7%) and the possible side effects of the vaccine 26/90 (28.8%). Public health messages provided by the Ministry of Health, primary physicians and social media are the most trusted sources of information, 268/281(95.4%), 236/281(84%), and 122/281(43.4%) respectively. After multivariate analysis patients who lost a family member or a friend (aOR3.26,95%C.I 1.7- 5.9,p=0.000) are significantly more likely to participate in the vaccination program. While female gender (aOR0.57,95% C.I0.36-.88, p=0.01), and patients who have already tested positive for the virus (aOR0.29, 95%C.I 0.17-0.52, p=0.000) are significantly less likely to enroll for the vaccine. Conclusion: Although there is a relatively fair acceptance of the COVID-19 vaccine among patients with IBD in Saudi Arabia, additional efforts must address the concerns that still hinder the vaccination program.