Protective Antibody Responses to Influenza A/H1N1/09 Vaccination in Children With Celiac Disease

Schäppi, Michela; Meier, Sara; Bel, Michael; Siegrist, Claire‐Anne; Posfay‐Barbe, Klara M.

doi:10.1097/mpg.0b013e318248e7be

Cited by 8 publications

(8 citation statements)

References 9 publications

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“…Studies in patients with type 1 diabetes, celiac disease, and IBD showed that individuals with these IMDs who are not treated with immunosuppressive agents generally have comparable serologic responses to vaccination as healthy individuals. 17-20 As several DMARDs and biologic agents interfere with the immune response to vaccines (Figure 1, Figure 2, Table 2, and Table 3), it is imperative to assess the patient’s immunization history at diagnosis and administer age- and disease-appropriate vaccines according to local guidelines prior to treatment initiation to optimize efficacy. Concerns regarding the risk of disease exacerbation are unfounded as studies have shown that immunization did not generally cause clinically significant worsening of underlying IMDs (Tables 2 and 3).…”

Section: Evidence Summarymentioning

confidence: 99%

Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies

et al. 2018

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Background:Patients with immune-mediated diseases on immunosuppressive therapies have more infectious episodes than healthy individuals, yet vaccination practices by physicians for this patient population remain suboptimal.Objectives:To evaluate the safety and efficacy of vaccines in individuals exposed to immunosuppressive therapies and provide evidence-based clinical practice recommendations.Methods:A literature search for vaccination safety and efficacy in patients on immunosuppressive therapies (2009-2017) was conducted. Results were assessed using the Grading of Recommendation, Assessment, Development, and Evaluation system.Results:Several immunosuppressive therapies attenuate vaccine response. Thus, vaccines should be administered before treatment whenever feasible. Inactivated vaccines can be administered without treatment discontinuation. Similarly, evidence suggests that the live zoster vaccine is safe and effective while on select immunosuppressive therapy, although use of the subunit vaccine is preferred. Caution regarding other live vaccines is warranted. Drug pharmacokinetics, duration of vaccine-induced viremia, and immune response kinetics should be considered to determine appropriate timing of vaccination and treatment (re)initiation. Infants exposed to immunosuppressive therapies through breastmilk can usually be immunized according to local guidelines. Intrauterine exposure to immunosuppressive agents is not a contraindication for inactivated vaccines. Live attenuated vaccines scheduled for infants and children ⩾12 months of age, including measles, mumps, rubella, and varicella, can be safely administered as sufficient time has elapsed for drug clearance.Conclusions:Immunosuppressive agents may attenuate vaccine responses, but protective benefit is generally maintained. While these recommendations are evidence based, they do not replace clinical judgment, and decisions regarding vaccination must carefully assess the risks, benefits, and circumstances of individual patients.

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Section: Evidence Summarymentioning

confidence: 99%

Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies

et al. 2018

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“…A prospective study on vaccination against influenza A/H1N1/09 among children with CD ( n = 14) and age-matched healthy controls ( n = 14) showed that CD patients achieved protective antibody titers comparable to the control group [ 52 ].…”

Section: Vaccination Immunogenicitymentioning

confidence: 99%

Vaccinations and Immune Response in Celiac Disease

2020

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Immune response to vaccinations in celiac patients is of growing scientific interest. However, some aspects of the relationship between celiac disease (CD) and vaccines are still unclear. A comprehensive search of published literature using the PubMed database was carried out using the following key terms: “adaptive immunity”, “celiac disease”, “humoral immune response”, “immunization”, and “vaccination”. To date, there is no evidence showing any causative association between vaccines and CD development. Therefore, vaccinations may be administered according to the modalities and timing of the National Immunization Schedule for each country. The rotavirus vaccine is currently recommended for the general population, and according to some data, it appears to reduce the risk for the development of CD autoimmunity in the early years of life. Regarding the hepatitis B virus, a booster dose of the vaccine is often required due to the low or the lost immune response rate in CD. Furthermore, determination of hepatitis B antibody titers could be useful in newly diagnosed CD subjects regardless of age at diagnosis. Finally, pneumococcal vaccines may be administered in patients with advancing age at diagnosis and concomitant risk factors. Future clinical practice guidelines for vaccination and monitoring programs in celiac patients could be recommended.

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“…In addition, children with CD have a higher risk of influenza infection and secondary hospital admission[21]. The increased infection risk in CD patients is probably due to several factors.…”

Section: Celiac Disease and The Risk Of Infectionsmentioning

confidence: 99%

“…The lack of response among CD subjects to HBV vaccination is important for public health policies because these non-responders may be a reservoir for HBV[43]. The published studies on the association between CD and HBV vaccination in children are presented in Table 1[11-21,24]. In the earliest report, involving 26 celiac patients aged 9.2 ± 4.6 years and 18 age-matched controls, receiving the full complement of childhood vaccination (HBV, tetanus, rubella, Haemophilus influenzae type b), Park et al[11] showed that a significantly greater percentage of children with CD did not respond to HBV vaccination in comparison with controls (53.9% vs 11.1%, P < 0.05).…”

Section: Responses To Vaccinations In Children With Celiac Diseasementioning

confidence: 99%

“…Therefore, they concluded that in children with CD, HAV vaccine produces a good immune response, almost the same as healthy controls, and that the routine HAV immunization protocol for healthy children may be utilized with success in these patients. A prospective investigation by Schäppi et al[21] about vaccine response in 14 pediatric patients with CD and controls matched for age and gender demonstrated that CD children achieved protective antibody titers comparable with the control group.…”

Section: Responses To Vaccinations In Children With Celiac Diseasementioning

confidence: 99%

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Immune response to vaccines in children with celiac disease

Anania

Olivero

Spagnolo

et al. 2017

WJG

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Celiac disease (CD) is an immune-mediated systemic condition evoked by ingestion of gluten and related prolamines in genetically susceptible subjects. The disease is featured by a variable combination of clinical signs, specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. Vaccination is the most potent intervention for infectious disease prevention. Several factors including age, gender, ethnicity, quality and quantity of vaccine antigen, doses, and route of administration can influence immune response to vaccination, although the main cause of variation in the responsiveness among vaccine recipients is host genetic variability. The HLA system has a fundamental role in identifying the antigens introduced into the host with the vaccines and in the development of specific antibodies, and some HLA phenotypes have been associated with a less effective immunological response. The available literature indicates that the immunological response to vaccines in CD children does not differ markedly from that of general population and antibody titres are high enough to provide long-term protection, except for hepatitis B virus vaccine. In this article, we review and discuss the scarce literature in this field in order to provide clinical practice guidelines to achieve the most efficient monitoring of the response to vaccines in pediatric CD patients.

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Protective Antibody Responses to Influenza A/H1N1/09 Vaccination in Children With Celiac Disease

Cited by 8 publications

References 9 publications

Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies

Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies

Vaccinations and Immune Response in Celiac Disease

Immune response to vaccines in children with celiac disease

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