Is the COVID-19 vaccine safe for people with Crohn’s or Colitis?

As with many vaccines, it is possible you may get some side effects after the COVID-19 vaccine. The most common ones include:

  • A sore arm where you had the vaccine
  • Feeling tired
  • Headaches
  • Muscle aches

These effects are usually mild and go away within a few days. People with Crohn’s and Colitis have similar side effects to the rest of the population, and these are usually mild. This is the case no matter what treatments you may be taking.

COVID-19 vaccines are not live vaccines (they do not contain any live virus). This means there’s no risk of it causing infection with COVID-19.

There is no evidence that having the COVID-19 vaccine will cause a flare-up in your Crohn’s or Colitis. A few people have reported having a flare-up soon after having the vaccine. But these numbers are similar to people who have not been vaccinated.

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. Speak to your IBD team too if you’re concerned.

Does having Crohn’s or Colitis affect how well the vaccine works?

Having Crohn's or Colitis does not make the vaccine any less effective. If you’re on a 5-ASA medicine or no medicine at all, the vaccine should work as well as for someone without Crohn's or Colitis. However, being on certain immunosuppressant medicines may make the vaccine work less well.

Vaccines work by ‘tricking’ your immune system into launching an attack against a virus before you have been exposed to it. If you are then exposed to the virus later on, your body is already prepared and protects you from getting ill. If you are taking immunosuppressant medicines, your immune system might not respond as well to the vaccine as other people’s.

Evidence from major studies such as CLARITY and VIP shows that people taking anti-TNF medicines, such as infliximab, or the JAK inhibitor medicine tofacitinib have a reduced response to the COVID vaccine. This can mean:

  • They produce fewer antibodies (proteins produced by your immune system in response to an infection)
  • There is a reduced T-cell response (these are types of cells that fight infection in your immune system)
  • They have a greater number of ‘breakthrough infections’ (infection with COVID-19 after vaccination)
  • Their protection after vaccination reduces faster over time

We can’t be sure yet whether other immunosuppressants have a similar effect. But there are promising results that azathioprine, ustekinumab and vedolizumab did not reduce vaccine response in studies.

If you were taking immunosuppressant medicines when you had your first (primary) COVID-19 vaccines, you should have been offered an extra (third) dose.  This extra dose should help to improve your protection.

Having a reduced response to the vaccines does not mean you should stop your treatment before getting vaccinated. 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. You may also be eligible for vaccine boosters. These help to improve your immune response against current strains (‘variants’) of COVID-19.

How can I get a booster vaccine?

Booster programmes have previously run in the spring and autumn, generally about 6 months apart.

The following groups are being offered booster vaccines as part of the autumn 2023 booster programme.

  • All adults aged 65 years and over
  • People aged 6 months to 64 years who have a weakened immune system (including people taking immunosuppressant medicines for Crohn’s or Colitis)
  • People aged 12 to 64 years who live with someone with a weakened immune system
  • People living or working in a care home for older adults
  • Frontline health and social care workers
  • People aged 16 to 64 years who are carers

This advice is the same throughout the UK, including England, Scotland, Wales and Northern Ireland. The NHS should contact you if you’re eligible for a booster vaccine, with information on when and where you can get your booster.


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