Immunisation and coeliac disease

• immunisations in patients with coeliac disease
  • if there is splenic deficiency (hyposplenism) then immunisation against pneumococus, meningococcal C, HIB and influenza is indicated
    
    
    • pneumococcal vaccination
      • the Coeliac Society (1) state '..Based on advice from our Health Advisory Committee, Coeliac UK recommends that everyone with coeliac disease is vaccinated against pneumococcal infection..'
      • the Green Book (2) notes that pneumococal immunisation is indicated for '...conditions such as homozygous sickle cell disease and coeliac syndrome that may lead to splenic dysfunction..' (2)
        
        
    • immunisation against haemophilus influenzae group B, meningococcal and influenza is indicated for individuals who develop asplenia or splenic dysfunction (2). There is no stated indication for these immunisations in coeliac disease patients without splenic dysfunction (2)
      
      
    • therefore in conclusion, the concensus seems to be that pneumococcal vaccination is indicated in coeliac disease per se. Other vaccines are indicated if there is hyposplenism

Reference:

1. http://www.coeliac.org.uk/ (Accessed 12/1/13)
2. The Green Book - Immunisation against infectious disease. Department of Health UK (Accessed 12/1/13)