COVID-19 vaccination in celiac disease patients

Dr. Isidro Jarque Ramos, Head of the Clinical Hematology Section, Hematology and Hemotherapy Service, University and Polytechnic Hospital La Fe, Valencia. FACE Scientific Committee.

Dr. Cristobal Coronel, Pediatrics Service of the Amante Laffón Health Care Centre, Seville. FACE Scientific Committee.

María van der Hofstadt Rovira, B. in Pharmacy, FACE Research Area.

Nowadays, COVID-19 infection is the most important health problem due to the global pandemic situation and the absence of effective treatments for the disease. Once infection occurs, the evolution of it in each person is unpredictable and the complications can be very harmful, even result in a potential death.

Until now, the only measures to prevent infection have been social distancing, hand hygiene and protection with masks. Nevertheless, after an unprecedented scientific effort, the European Medicines Agency (EMA) has recently approved the first vaccines for immunisation in the European Union: the Pfizer-BioNTech vaccine, Comirnaty® or CBNT162b2; the Moderna® or mRNA-1273 vaccine; the Oxford/AstraZeneca® or ChAdOx1n-CoV-9 vaccine; and the recently licensed Janssen vaccine. Many others are in development and soon to be marketed.

Vaccination is an excellent measure to achieve individual immunity and contribute to herd immunity in the medium term, which is what will ultimately control the pandemic. Clinical trials have been done in healthy volunteers and not in patients with coeliac disease, but, considering the potential severity of COVID-19 infection, the general recommendation for coeliac patients is to take the vaccine when it is offered, unless they have a specific reason to not be vaccinated. As so far, at present, there is no evidence to indicate that coeliac patients are at a higher risk of developing adverse effects.

In fact, in recent days, there have been many scientific societies that support vaccination in these and other patients, as can be seen in the document published by the Spanish Society of Digestive Pathology (Sociedad Española de Patología Digestiva). In this regard, the Spanish Society of Digestive Pathology states that: “Generally speaking, and in view of the scientific evidence available at the present time (December 2020), vaccination is preferable to non-vaccination in all people, with or without digestive diseases”. This is also supported by the recommendations published by the European Society for the Study of Celiac Disease (ESsCD) and the American Society for the Study of Celiac Disease (SSCD).

The only contraindication to the vaccine is allergy to the active ingredient or to any of its components, which can be consulted in the package leaflet available on the website of the Spanish Medicines Agency (AEMPS). It ought to be borne in mind that celiac disease is not an allergy and, in itself, does not require any additional precautions when administering the vaccine. Of course, patients with concerns about the vaccine and their particular circumstances should consult their general practitioner. Finally, it should be noted that the mechanism of each vaccine is different. For further information regarding the vaccines, please consult the European Medicines Agency (EMA) latest information at  https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/treatments-vaccines/covid-19-vaccines.

April 2021
Translation by Ana Prats