Vaccinations

PNEUMOCOCCAL VACCINE

Pneumococcal disease is an infection caused by a bacterium that usually lives harmlessly at the back of many people’s throats. However, it can invade other parts of the body and cause serious, possibly life-threatening illnesses including pneumonia, septicaemia or meningitis.

Department of Health position

The Department of Health recommends a vaccination for pneumococcal disease for:

• infants
• people aged 65 and over
• people aged between 2 and 65 years of age who are at higher risk from pneumococcal disease, including individuals with a damaged or absent spleen
• children and adults with certain long term health conditions such as serious heart, liver and kidney conditions and diabetes.

Some people with coeliac disease have been found to be ‘hyposplenic’ (1, 2). This potentially puts them at risk of pneumococcal infections and those people who are known to be hyposplenic should receive the pneumococcal vaccine and also vaccines to meningitis C and influenza. However, the Department of Health has not made a universal recommendation to everyone with coeliac disease, but rather recommends that clinical assessments are made on an individual basis.

Coeliac UK position

Based on advice from our Health Advisory Committee, Coeliac UK recommends that everyone with coeliac disease is vaccinated against pnemococcal infection. This is based upon the potential for people with coeliac disease to develop overwhelming pneumococcal sepsis due to hyposplenism. Since 2006, all infants receive vaccination against pneumococcal infection as part of the routine childhood immunisation programme. Therefore, at the moment this recommendation will require a one-off vaccination for children and adults born before 2006.

References

(1) Walters J R F (2008) Coeliac disease and the risk of infections. Gut

(2) William B M (2007) Hyposplenism a comprehensive review part 1 basic concepts and causes. Hematology. 12 (1): 1-13

Flu

There is no evidence that people with coeliac disease are at a greater risk of getting seasonal flu or swine flu than the general population.

The need for vaccinations should therefore be assessed on an individual basis.

Tamiflu, the drug used to treat swine flu, as with all UK prescription medications in the BNF and MIMMS, is gluten-freeWhen a food has less than 20 parts per million (ppm) of gluten so it is safe for people with coeliac disease to eat. .

More information on vaccinations is available on the NHS Choices website.