About IBD Podcast Episode 85 - Dr David Rubin Answers COVID-19 Vaccine Questions

About IBD Podcast Episode 85 – Dr David Rubin Answers COVID-19 Vaccine Questions

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From the beginning of the COVID-19 pandemic, people with inflammatory bowel disease (IBD) have had many questions. Now that vaccines against the virus are becoming available, people living with Crohn’s disease or ulcerative colitis need even more information in order to make decisions. I asked Dr David Rubin, Chief of the Section of Gastroenterology, Hepatology & Nutrition and the Co-Director of the Digestive Diseases Center at The University of Chicago Medicine to answer some of these initial questions about the first COVID-19 vaccines (manufactured by Pfizer and Moderna). Topics discussed on this episode include:

  • How vaccines work
  • How mRNA works
  • How IBD medications affect the immune system
  • IBD medications and their potential effect on COVID-19 vaccination
  • When we’ll have more information about COVID-19 vaccines and IBD
  • Why side effects with vaccines are expected and what they mean

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Find David T. Rubin, MD at The University of Chicago Medicine, Twitter, Rubin Lab, Rubin’s Reflections (Blog), and Cornerstones Health.

Find Amber J Tresca at AboutIBD.com, Verywell, Facebook, Twitter, Pinterest, and Instagram.

Credits: Mix and sound design is by Mac Cooney. Theme music, “IBD Dance Party,” is from ©Cooney Studio.

Key Quotes:

  • The first thing is to remember that inflammatory bowel disease itself is a condition where in almost all situations, the immune system is overactive. So having Crohn’s disease or ulcerative colitis is not a situation where you’re immune deficient.
  • So IBD patients in all the analyses during COVID have not actually been found to be at increased risk for getting infected, or at increased risk for developing COVID as having just because they have Crohn’s or colitis or have an ostomy or have a j pouch.
  • The messenger RNA is degraded within a couple days it’s out of your system doesn’t hang around. It doesn’t ever enter the nucleus of cells, it doesn’t become a permanent part of your genetic material in your body. And therefore that’s why it is thought to be extremely safe.
  • But I want to make it clear to everyone that they didn’t just decide to do this in February, March. This was something that actually was in development, it just got pushed through because of the critical nature of the pandemic.
  • … there are no data to say that vaccination triggers IBD. And it’s been looked at carefully in many studies. And there’s no data to show that getting a vaccine triggers a relapse of your IBD. And the newer vaccines that we’re talking about here, will not do that either.
  • …we don’t know for sure yet is whether you’ll have impaired ability to mount a protective immunity at the same level as if you weren’t on therapy. But that doesn’t mean you won’t develop any immunity. And in fact, it’s possible that you’ll develop the same immunities to general population because the messenger RNA vaccine is a completely new mechanism.

Dr Rubin’s Tweets and Tweetorials:

Further Reading:

Scholarly Publications:

Episode Transcript (Rough)

[Music: IBD Dance Party]

I’m Amber Tresca. And this is About IBD. It’s my mission to educate people living with Crohn’s disease or ulcerative colitis about their disease, and to bring awareness to the patient journey.  Welcome to Episode 85. My guest is Dr David Rubin, who is Chief of the Section of Gastroenterology, Hepatology & Nutrition and the Co-Director of the Digestive Diseases Center at The University of Chicago Medicine.

Dr Rubin is well-known and respected in the field of gastroenterology and he specializes in caring for patients with IBD. I asked him to talk to me specifically about the new COVID-19 vaccines and what IBD patients can expect. He covers the basics of vaccination, how the COVID-19 vaccines were created and why they’re safe, as well as the different IBD drugs and how they might affect the effectiveness of a COVID-19 vaccine.

There’s a lot of information in this episode about COVID-19, the new vaccines, how IBD medications work, and what we can look for in terms of information about the pandemic over the next several months. You may want to save this episode and listen to it more than once. If you’re like me and you like to read something to help understand it better, you may also want to look at the transcript on the Episode 85 page on about IBD.com. You can also look in the show notes for more links and citations.

Thank you so much, Dr. Rubin for coming on About IBD.

David Rubin, MD 1:38
It’s absolutely My pleasure, Amber, thank you for having me, and obviously an important topic.

Amber Tresca 1:43
Yes, I really want to get to the bottom of some of these initial questions that people in the IBD community and also when the larger chronic illness community have, I realized that it’s going to be a little bit before most of us have access to vaccines. But there are health care workers who also have IBD, or other chronic illnesses, and they’re getting access to the vaccine sooner than the rest of us. So I’m glad that we can get some information out there for them. So the first thing I want to ask you about is that there’s a bunch of different vaccines in development. Can you tell me a little bit about the differences between these vaccines?

David Rubin, MD 2:20
Absolutely. The first thing to remind everyone about is what a vaccine is supposed to do. The point of vaccination and a vaccine is to trigger our body’s own immune system, so that it recognizes a what we call an antigen, which is an infectious agent or some other protein, so that the body can react to it and protect us. Our immune system exists to protect us and to distinguish between things that our body needs and things that could harm us. And, therefore, vaccines are designed to trigger that immune system to develop those protective antibodies so that they’re waiting in the wings when we need them. And if you’re exposed to the agent of concern your body can protect you from getting sick from it. So the different vaccines that are in development against the Coronavirus, what we call SARS-COV-2 have different technologies, some of which are the older technologies for existing vaccines that we already have and have been exposed to most of us like measles, mumps and rubella or influenza. And some of them like the most recent two from Pfizer and Moderna are using a new technology called messenger RNA.

The different approaches to vaccines, the older ones were in the early days, they would actually take a piece of the actual virus and even live virus particles at a very small titration to trigger the immune response. And while that can have benefits of developing an immunity against the organism, it can also have risks because you’re getting a live virus which might actually replicate in your body and give you the illness. There is in fact a live virus vaccine against Coronavirus that is in development is unlikely to be used in most parts of the world but it right now is being developed in India. And so that may be part of what will be rolled out for some portions of the of the globe.

The other would be where they extract pieces of the protein that encode the virus remember Coronavirus is an RNA virus it has RNA as its main genetic material and the proteins around it are what triggers the immune reaction. So they actually use some of those proteins and then they deliver them in different ways to our body to have an immune reaction. One way is they use an actual other virus called an adenovirus has what we call a vector to carry the protein into the body. And there are adenoviruses viruses that are non replicative, meaning that it carries the protein into your body and helps your immune system react. But the adenovirus doesn’t go anywhere. It doesn’t replicate, it never becomes anything and it goes away.

And then there are some that actually allow that to replicate until the body reacts and gets rid of it. The messenger RNA vaccines are completely different. They’re using a small component of messenger RNA that codes for one of the key proteins on the outside of the Coronavirus called the spike protein. Messenger RNA is part of our genetic machinery that codes for how our body makes proteins. So the messenger RNA codes for the spike protein to be manufactured in our body. And that triggers an immune response that then protects us from Coronavirus because if you get infected or exposed to Coronavirus, specifically SARS-COV-2, your body recognizes that protein on the surface as something that it’s already been protected against, and then you react to it and protect you.

The messenger RNA is degraded within a couple days, it’s out of your system doesn’t hang around. It doesn’t ever enter the nucleus of cells, it doesn’t become a permanent part of your genetic material in your body. And therefore, that’s why it is thought to be extremely safe. And the effectiveness as we’ve seen in the results from both Pfizer and Moderna, you know, are in the range of 94-95% effective meaning people who get the two injections have a 95% protection against having the Coronavirus disease called COVID-19.

So I know that was a lot of information, Amber, but hopefully I’ve sort of outlined some of the different vaccines and how they work.

Amber Tresca 6:47
That was fantastic. Are these the first mRNA vaccines?

David Rubin, MD 6:51
mRNA technology was developed and has been in, in development for 10 years, they were working on this. But these are the first that have made it to humans that I’m aware of. I haven’t seen it anywhere else. But I want to make it clear to everyone that they didn’t just decide to do this in February, March. This was something that actually was in development, it just got pushed through because of the critical nature of the pandemic. And because the FDA developed that rapid regulatory pathway and the companies developing it started actually producing the vaccine before they even knew they were going to have results so that they could be ahead of the game here and have some of it for distribution as soon as it got its approval.

Amber Tresca 7:36
I think that’s a part of the conversation that’s really been missing, because I’m hearing a lot from people who are concerned that things were rushed, that maybe shortcuts were taken. But that’s that’s actually not the case. And the reason why they’re asking that is because they’re concerned about safety. Of course, we’re all concerned about safety. What kind of information do we have so far about the safety of these vaccines?

David Rubin, MD 7:58
It’s a very important question. I actually tweeted out this morning, because today, when we’re recording this on December 12, was the FDA press release, press conference announcing the emergency use authorization for the Pfizer vaccine. And what I tweeted out was that both the director of the FDA as well as the Director of the Division within the FDA that looks at biologicals, which includes vaccines, use the term safe and effective.

The reason I emphasize that is actually the FDA’s origins were on safety, the organization the agency was created first to make sure our food was safe. And then to make sure our drugs were safe. And efficacy became a part of the regulatory pathway later. And they emphasize this because the safety of these vaccines was not compromised in their development in any way. That despite the fact that they had an abbreviated regulatory pathway. That just means that they were able to review things faster.

The rest of it in terms of how much data they needed to do an emergency use authorization, which is what they’ve granted to Pfizer, as of this recording, is hasn’t been compromised in any way. And it’s been completely transparent.

The vaccines these particular vaccines are designed to be reactogenic, they are designed to cause a reaction in your body. That’s how your body develops immunity. And so there we have to distinguish what we would call side effects or safety concerns from what are the expected effects of the vaccine because it’s triggering an immune response.

The majority of what was seen in the people who received the actual vaccine and not placebo, were the expected effects of an immunogenic vaccine. And those were headache, some nausea, some muscle aches, certainly soreness at the site of the injection. There were not any significant safety concerns identified, certainly not within the limits of what they’ve done.

And there are two ways to think about safety. Number one, is the number of people who got exposed to the agent of interest. So you want to have as many as possible so that any potential signals will come out. And number two, is how long you follow them, after they’ve had the injection. And the way to think about duration in terms of what’s relevant: there’s the immediate hypersensitivity or the immediate reactions or safety concerns that may occur.

And then there are the short term in terms of the length of the study itself, and then the longer term. So up to the length of the study so far, there haven’t been concerns raised at all, the studies are designed for two year follow up. And of course, there’ll be much larger, longer term, post marketing surveillance studies to look at additional safety as we follow out. But the reassurance from scientists and those who have looked at this, including my colleagues, has been very positive that this has not been something we need to worry about. And I certainly in my own review, agree with that.

Amber Tresca 11:13
So right now, the FDA has granted an emergency use authorization, but that is different from an approval. Is that right?

David Rubin, MD 11:24
That’s correct. So there’s a distinction there between what emergency use authorization is, it lets the FDA give authorization to something before it completes the two year follow up, which is what the plan is for the additional follow on. But the reason that you have emergency use, it allows unapproved vaccines are other medical products to be used in an emergency to diagnose, treat or prevent other problems. In this case, we’re trying to prevent COVID-19. And it’s also something that’s used when there are no other options currently on the market are available that would substitute for this. So that’s why they call it an emergency use authorization.

Amber Tresca 12:10
So because some people in the IBD community and the chronic illness community are immunocompromised because of for instance, medications might be one reason that they’re immunocompromised. They’re wondering where their place might be in this in this line for the vaccines. Do you have any thoughts about about that yet for IBD patients?

David Rubin, MD 12:32
Well, first, you can go to the CDC website. And you look under the part of the CDC website, which is the Advisory Committee on Immunization Practices, the ACIP. And that entire committee exists to help guide us in the use of all vaccines. This isn’t just this vaccine, but they’ve been publishing and writing and posting on the web, their recommendations for COVID-19 since before we had the vaccine approved in the last few days.

And the recommendation is that and their survey of their committee has been health care workers and residents of long term care facilities like nursing homes should be first in line. And then the second huge group of people, it’s something like 110 million Americans are those who have immune conditions or chronic illnesses that put them at risk. Otherwise, the inflammatory bowel disease population will fall into that category.

So they’ll be earlier than the general population. But they’re not the very first ones to get it unless, as you already mentioned, it’s somebody who has inflammatory bowel disease and their health care worker or otherwise, on the front line.

I want to address something that is sometimes confusing, and I want to be clear about it. The first thing is to remember that inflammatory bowel disease itself is a condition where in almost all situations, the immune system is overactive. So having Crohn’s disease or ulcerative colitis is not a situation where you’re immune deficient. Sometimes people confuse that basic fact about the diseases. This is a condition where that immune system of your intestines which is there, again, to protect you and to distinguish between nutrition, and infections and other things that could harm you.

That immune system is being either continuously stimulated by something we haven’t found despite 100 years of looking for it, or that it’s lost its regulatory control. In other words, it’s lost the off switch. It’s normal for our immune system in our intestines to get mildly inflamed every time we eat, and certainly to get very inflamed if we get food poisoning. And the difference though, between that and when someone has inflammatory bowel disease, as you know, is that people who get mildly inflamed after eating or who have food poisoning their immune system shuts off and people with inflammatory bowel disease, one of the challenges is that their immune system is in overdrive, or keeps going, which is what causes symptoms and causes damage.

The reason I’m mentioning that is because I want to then point out that the therapies we use for IBD, when they do what we want them to do, are designed to turn down that immune response long enough for the body to take over and to control itself. So we’re not trying to immune suppress people with the therapies we use in IBD. And fortunately, most of our newer therapies are actually pretty good at just turning the dial down long enough for the body to actually take over.

So when we talk about things like the bowel healing with the medicines we use for IBD, we’re actually talking about the body healing itself, not the medicines healing the bowel, the way the medicines helped about heal is they take away the inflammatory reaction, and then the body’s usual tools to heal the lining of the intestine take over. So IBD patients in all the analyses during COVID, have not actually been found to be at increased risk for getting infected, or at increased risk for developing COVID as having just because they have Crohn’s or colitis, or have an ostomy or have a jpouch.

In addition, being unstable maintenance therapy, for the most part has not been associated with worse outcomes. There are some analyses more recently that suggest if you’re on combination immunotherapy with a biologic and an immunomodulator, like methotrexate, or is the bioprinter, six mercaptopurine, that if you’ve got COVID, you might be at risk for having a worse outcome, like being in the hospital or getting pneumonia or having an ICU admission.

And that has led people to say, well, maybe we shouldn’t leave people on double drugs when they get sick. It doesn’t mean that we pull off therapies and let people relapse from their IBD. So I just want to be clear about this. Because I don’t want people thinking that if they’re waiting their place in line for the vaccine, they’re at this higher risk, you’re not a decreased risk, but you’re not at higher risk either.

And being patient, and getting it in that second tranche of people in the US is going to be okay. And in the meantime, of course, keep doing what you’re doing to protect yourselves and your family.

Amber Tresca 17:18
Yeah, that’s a good point. We still even after receiving the vaccine, we still all need to keep our distance wash our hands wear a mask, all of those things.
There are a lot of different medications, they have different mechanisms of action for IBD. Are there any concerns? Or are there any concerns that are anticipated? Between IBD medications and the vaccines?

David Rubin, MD 17:52
It’s a very important question, and one that I weighed in on a little bit in one of my tutorials a bit ago. But in order to answer that question, ideally, we need to see the effect of the messenger RNA vaccines in our patients who are receiving those therapies. We don’t have those data yet.

So in the absence of that we have to rely on what do we know about vaccines in general and the treatments we use an IBD. What we’ve seen over the years, is that patients who are on thiopurine therapies which again is a is a fire print, or six MP and who receive the pneumonia vaccine, which is recommended for patients who are on any of these therapies are less likely to develop the protective immunity with the pneumonia vaccine. That does not mean that they’re at higher risk for having a reaction or having safety concerns from getting the pneumonia vaccine. Nor does it mean that you don’t develop any immunity from the pneumonia vaccine.

So we can think that perhaps thiopurines based on the older data might limit our ability to develop an immune response. Now to get into the weeds a little bit just with one sentence. One of the ways thiopurines predominantly works is it affects the lymphocytes, which is part of our white blood cells that are specifically a component of them that make antibodies, so you can understand why a drug that affects your lymphocytes might impair your ability to develop antibodies to a vaccine. That’s also by the way, why thiopurines are the most commonly used therapy combined with a biologic to prevent you from developing anti drug antibodies to the biological therapy, like anti TNF infliximab, what you may know as Remicade or Inflectra, Remsima or Humira because it prevents antibodies to the drug. S

o, on the one hand, we want to protect people from developing immunity against the biologic that’s treating their IBD. On the other hand, we don’t want them to prevent you from developing immunity when you get a vaccine. So just the balance there and understanding this. There also have been data that say that you’re less likely to develop immunity to influenza vaccination, if you’re on thiopurines. And there are some data to suggest that if you’re on an anti TNF drug, it might impair your immunity.

So when we talk about whether people with IBD on those particular therapies that I’m talking about now, are going to not respond properly to the messenger RNA vaccines, there’s a couple things to keep in mind. Number one is, none of us believe that there’s going to be a safety concern of you getting the messenger RNA vaccine. Nobody has said that.

Number two is what we don’t know for sure yet is whether you’ll have impaired ability to mount a protective immunity at the same level as if you weren’t on therapy. But that doesn’t mean you won’t develop any immunity. And in fact, it’s possible that you’ll develop the same immunity as the general population because the messenger RNA vaccine is a completely new mechanism. And so it may work just fine based on what we’re understanding, and some have suggested it will.

And number three, of course, is that we want to certainly follow and study and gather the information about our patients who get these to know number one, do they mount the same immune response and number two, does it last as long as we want it to. In other words, will it last a whole year or in perpetuity is the one is the two injection is going to give us protection from this particular Coronavirus forever.

In regards to other therapies. If you’re receiving the drug called anti vedolizumab, that’s a therapy that impairs the body’s ability to send some white blood cells to the intestinal immune system. And it’s selective to your gut immune system, so it doesn’t affect the rest of your body. It’s not believed that being on Entyvio will impair your ability to develop an immune response to the vaccines that are being developed against Coronavirus.

If you’re receiving the drug called Stelara, which is also called ustekinumab. It is not believed that this will necessarily impair your immune response to these vaccines. That’s a drug that targets a very specific protein in your immune system. And it’s not that that that would impair your body’s ability to respond to a vaccine. If you’re receiving the therapy called Xeljanz, which is the oral therapy and ulcerative colitis, also called tofacitinib. This is also a therapy that has an effect on the body’s ability to make inflammatory proteins. But we don’t think it’s going to necessarily impact your ability to develop immunity.

And we’re not going to be withdrawing therapies when we vaccinate our patients. I will add that Pfizer, the makers of Xeljanz and the makers of the first mRNA, that has emergency use authorization are going to be studying specifically whether patients with rheumatoid arthritis taking Xeljanz might benefit from a pause in their therapy when they get vaccinated.

We in the IBD community are not recommending anything like that right now. We don’t want you to take a risk of having a relapse of your IBD. by stopping your therapy based on inadequate information, we do not recommend that you would do that.

Amber Tresca 23:28
Which is the same for this whole pandemic. In the beginning, people wondered if they should stop taking their drugs in the beginning and the recommendation was, yeah, don’t, keep taking things.

David Rubin, MD 23:39
Yeah, I mean, the whole point, there were many reasons we said that in the early days, it was the last thing we want is for you to get sick from your Crohn’s disease or your colitis, and need hospitalization or health care resources when we were limited in our ability to provide it.

But also, we said there’s no good reason to think that the therapies you’re receiving which are supposed to be normalizing your immune system to control your inflammatory bowel disease, are putting you at higher risk.

And in fact, there were old studies from the earlier Coronavirus epidemics that emerged in the Middle East and in Asia in the early parts of the 2000s. And the 2000 10s that suggested that these therapies were okay. And even that there may be some anti viral effects of some of these older drugs, or at least anti inflammatory effects for the phase of COVID that caused pneumonia and close to death. And now, in fact, there are data to suggest that some of these therapies may actually treat that face of COVID. So being on them for your IBD may be protecting you from that outcome.

Amber Tresca 24:42
Are we going to know at some point the effectiveness of the COVID vaccines in people that have IBD and are receiving some of these medications? Like do you think that there’s a timeline that we can put on there?

David Rubin, MD 24:54
Well, for sure, we’re going to know because there are going to be additional studies like that performed in In real time, so multiple places are going to be collecting these data. We’re part at the University of Chicago. We’re part of a multicenter effort to do this, we also developed our own analysis that we’re going to be doing to look deeply at the immunology of this whole situation in our patients. And those data will be coming out as rapidly as some of the data we heard early in the COVID pandemic about IBD.

I will add that the Crohn’s & Colitis Foundation has issued a new website and will be updating their information in real time regarding the vaccines, and the International Organization for the study of IBD called IOIBD. On their website, which is IOIBD.org has a site, a whole section committed to the COVID pandemic. And IOIBD is having a consensus meeting on December 18, to ask the world experts in IBD, about their understanding and recommendations for the IBD population.

And when we worked on the consensus statements to send it out for everyone to vote, we thought carefully about the questions. You’re asking me right now Amber, and we’re going to get the best evidence and advice from the experts around the whole world to be able to provide it to the IBD community so that we’re being consistent, and we’re providing them with reassurance.

Amber Tresca 26:20
Some people have been concerned that receiving a vaccine could trigger an IBD flare up. Is there anything to that concern?

David Rubin, MD 26:29
No, I don’t want them to think that because if we even start with the old vaccines, there are no data to say that vaccination triggers IBD. And it’s been looked at carefully in many studies. And there’s no data to show that getting a vaccine triggers a relapse of your IBD. And the newer vaccines that we’re talking about here, will not do that either.

So I don’t want people to worry that somehow that’s going to happen, I understand where the where that comes from, which is if you’re revving up my immune system to develop antibodies against the Coronavirus, spike protein, will that rev up my immune system in the gut and activate my Crohn’s or colitis, there’s a nice train of thought there. But the type of immune response we’re talking about is different. And that’s shouldn’t be the case at all. We’re not expecting that in anybody.

Amber Tresca 27:25
One thing that has been on my mind is that we need to receive at least these first couple of vaccines that are coming out in two doses, which means that you have to go back and get a second dose. What are your thoughts on that how, you know, some people are going to fall off here, or how many people do you think might not come back for that second dose?

David Rubin, MD 27:46
Yeah, the logistics of it are really important, and people need to pay attention to this. The first dose is called the primer or the prime. And when you get that and you get exposed to the spike protein, your body will react to it. But it won’t, in most situations, be thought to trigger any kind of memory. In other words, your body won’t remember that it was exposed, we’ll just have the reaction in the short term.

Because remember what I said, the messenger RNA degrades quickly, and the protein it’s making to trigger the immune response is going to go away. But the way the immune system works is pretty remarkable.

And the second dose is called the booster. When you get exposed to the second dose, the body will say, Aha, this is a problem that I need to remember. And it will then activate a different set of what are called memory T cells. And those cells then actually will remember this. And the memory B cells are the ones that actually are will result in durable immunity. And that’s what you want. And that’s how you get it.

So if somebody has a headache and feels lousy, after the first injection, and then they think they’re not going to go for the second one because they didn’t feel well. They’re going to be selling themselves short. Remember that the vaccine is expected to induce a reaction. If you don’t have one, that doesn’t mean it’s not working. But if you do, you should not be alarmed that this is wrong. And you definitely shouldn’t use that as an as a measure that you don’t need the second one or that you should avoid it because you didn’t feel well for a day or two. You’ve got to stick to the plan. It’s very important for people to remember that so that they get that durable immunity.

Amber Tresca 29:32
Well, that was my last question for you. Do you have anything else that you want to add or anything that we missed?

David Rubin, MD 29:38
Well, first of all, I want to thank you for all of your advocacy and these programs. But especially right now when it’s important that people have reliable, updated information that we’re all paying attention, and that we are reassured by the careful work that’s been done by some really smart people, not just at the FDA and industry. But all those individuals out there who are working together to try to make sure this goes away and that our patients stay safe.

Amber Tresca 30:07
Thank you so much, Dr. Rubin, you are always one of the first ones to come out and answer the questions before I have even formulated them. And so I really appreciate all that you do for patients and also just being available to me after you were already having a busy day today. So thank you so much.

David Rubin, MD 30:24
This is very, very important to everybody. And perhaps we can have another conversation when we have some more information and we’ll keep everyone updated.

Amber Tresca 30:32
Oh, I was hoping that you would say that. So yes, perfect.

David Rubin, MD 30:35
Okay, you take care and happy holidays.

Amber Tresca 30:38
Same to you. Thank you so much.

Hey, super listener.

A special thank you to Dr David Rubin for making time to discuss the COVID-19 vaccines with me, as well as all he does day in and day out for the IBD community. His commitment to patient education is incredible and we are so fortunate to have him working on our side. Dr Rubin is an excellent follow on Twitter. His handle is @IBDMD. He often posts wonderful educational Tweetorials, and I will link to some in the show notes and on the Episode 85 page on my site, aboutIBD.com.

If you’re a regular listener you may remember Episode 75, where I talked to Dr Dermot McGovern about The Sherman Prize. The Sherman Prize is awarded each year to those who are making great contributions to the field of research and care in IBD. Dr Rubin won The Sherman Prize for 2020, and I completely forgot to congratulate him during this interview. So, I’ll do it now: congratulations on an honor that is so well-deserved.
While you’re on the Twitter, don’t forget to follow me as @aboutIBD, as well as on Instagram and Facebook. I will keep you updated on the latest with the COVID vaccines as well as with news and information that’s important to people who live with IBD. If you haven’t already, make sure you subscribe to this podcast and if you’re so inclined, leaving a review in your podcast app will help other people find the show too.
Thanks for listening, and remember, until next time, I want you to know more about IBD.

About IBD is a production of Mal and Tal Enterprises.

It is written, produced and directed by me, Amber Tresca.

Theme music is from Cooney Studio.

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