Entyvio and the COVID vaccine, what should I know?

Should I get a COVID-19 vaccine if I am taking Entyvio?

The Crohn’s & Colitis Foundation recommends that all patients taking Entyvio get vaccinated against COVID-19 with a COVID-19 vaccine, unless advised otherwise by their doctor.

I am prescribed Entyvio. What COVID-19 vaccine should I get?

You should get whatever vaccine is available to you because comparison trials have not been done to show that one vaccine is any better than the other in patients taking Entyvio.

All the COVID-19 vaccines were rigorously tested for safety and effectiveness in clinical trials. The currently approved vaccines do not contain live virus particles. There is no concern of patients taking Entyvio contracting COVID-19 from non-live vaccines. Non-live vaccines are considered safe for IBD patients regardless of the type of IBD therapy the patient is receiving. Patients with IBD can usually mount a normal immune response to vaccines, and 3 studies, the CORALE-IBD, ICARUS Study, and the PREVENT COVID have all shown IBD patients who received both doses of an mRNA vaccine mounted an immune response. Those on anti-TNF treatment (such as Humira and Enbrel) and corticosteroids may have a reduced immune response to certain vaccines.

How many COVID-19 vaccines should I get if I am prescribed Entyvio?

The Pfizer-BioNTech and Moderna vaccines each require two doses (shots) and rely on messenger RNA technology to teach the immune systems to recognize and defend against SARS-CoV-2, the virus that causes COVID-19. The Johnson & Johnson vaccine is a one-dose option, which uses a harmless, genetically modified adenovirus to prime the immune system against SARS-CoV-2.

If you have any allergies to vaccine ingredients, check with your doctor about what vaccine is best to take beforehand.

Talk to your doctor about whether they recommend 2 doses, 3 doses, or 4 doses of either the Pfizer or Moderna vaccine. Currently are no recommendations from the FDA or CDC regarding an additional dose of the Johnson & Johnson vaccine. Recommendations and expert guidelines differ as to how many vaccine doses should be given to people taking IBD medications, such as Entyvio.

The purpose of another dose is to boost the immune response, particularly in people who are on immunosuppressive treatments, with an organ transplant, or who have received cancer chemotherapy. Patients with IBD are not considered to be in any of these categories, and many studies have confirmed that their response to the vaccines is appropriate and that most do not need an additional dose.

The Advisory Committee on Immunization Practices (ACIP) recommends an additional dose of mRNA COVID-19 vaccine for moderate to severe immunocompromised individuals and to individuals on the following therapies.

• High-dose corticosteroids (defined at ≥20mg / day of oral prednisone)
• Anti-TNF biologics and biosimilars
• Immunomodulators (azathioprine, methotrexate, etc.)

Other expert organizations, such as Crohn's and Colitis Canada support a 4th dose of a COVID-19 vaccine in IBD patients who have moderate or severely active inflammation, moderate or severe malnutrition, or require parenteral nutrition (intravenous nutrition through a central line). Additional doses may also be useful in people who have taken Entyvio and systemic steroids (prednisone, methylprednisolone, hydrocortisone) at any time after their first COVID-19 vaccine. Steroids have been demonstrated to result in a faster decrease in antibodies to COVID-19 in vaccinated individuals.

Related questions

• How much does Entyvio cost per month?
• Is Entyvio an immunosuppressant or a biologic?
• How long does it take Entyvio to start working?

I am taking Entyvio should I schedule in my COVID-19 vaccination at a different time?

Although there are no specific guidelines regarding timing of your COVID-19 vaccine with your Entyvio injection, some experts suggest separating administration to avoid confusion with side effects relating to either the vaccine or your IBD medication.

• Try to avoid having a COVID-19 vaccination 2 days or less prior to your Entyvio injection.
• Time your COVID-19 vaccine so it is not due on the day of, or the day before you are due for another Entyvio injection.

Do I need a COVID-19 vaccination if I have already had COVID-19?

Yes. It is unknown how long immunity from COVID-19 lasts, and some people can get COVID-19 more than once.

Am I at higher risk of severe COVID-19 with Entyvio?

Research has shown that most people with inflammatory bowel disease (IBD) are at no more risk of severe illness from COVID-19 than the general population without IBD. Even though Entyvio is not considered a whole-body immunosuppressant, it is still associated with an increased risk of infections, some of which may be serious. There have been no studies to show that people specifically taking Entyvio are at a higher risk of severe COVID-19.

What else can I do to protect myself from COVID-19 while taking Entyvio?

The Crohn’s & Colitis Foundation encourages people taking Entyvio to also wear masks, social distance, wash their hands frequently, and adopt other strategies designed to mitigate the spread of the coronavirus.

The CDC and ACIP do not recommend checking antibody levels currently.