Hepatitis B vaccination failure in celiac disease: Is there a need to reassess current immunization strategies?
Abstract
Human leukocyte antigen (HLA) phenotype DQ2 is considered the most important genetic marker for un-responsiveness to hepatitis B vaccine. Since celiac disease (CD) is also strongly associated with the same haplo-type it may be hypothesized that celiac patients are less able to respond to the vaccine. We report a retrospective study on celiac patients vaccinated with three doses of 10 microg at 3, 5 and 11 months of age by an intramuscular injection of a recombinant hepatitis B vaccine (Engerix B). We found 30 of 60 celiac patients (50%) unresponsive to vaccination and a significant higher number of responders among patients younger than 18 months at the time of celiac disease diagnosis. Our study confirms that celiac patients have a lower percentage of response to hepatitis B vaccination than healthy subjects. These findings provide useful information to evaluate if current vaccine strategies should be reassessed and if revaccination should be recommended.
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Several studies detected no differences between coeliac disease children and controls in the immune response to poliomyelitis, diphtheria, mumps, pertussis, rubella, tetanus, haemophilus influenzae type b, and measles.
“Several studies detected no differences between CD children and controls in the immune response to poliomyelitis, diphtheria, mumps, and pertussis (45), rubella, tetanus (45, 46), haemophilus influenzae type b (46) and measles (45, 47).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [45]
Cites
Failure to Respond to Hepatitis B Vaccine in Children With Celiac Disease
Park, S., Markowitz, J., Pettei, M., Weinstein, T., Sison, C. P., Swiss, S. R., & Levine, J. (2007) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e3180320654 · Cited by 84 · see citing works
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186 · see citing works
Response to Hepatitis A and B Vaccination in Pediatric Patients With Celiac Disease
Urganci, N., & Kalyoncu, D. (2013) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e31827af200 · Cited by 25 · see citing works
- Authors
- Leonardi, S., Spina, M., Spicuzza, L., Rotolo, N., & La Rosa, M.
- Affiliations
- University of Catania (IT)
- Corresponding author
- Leonardi, S.
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 27
- Issue
- 43
- Pages
- 6030-6033
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W2056089638
- Cited by
- 67
- References
- 1
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 11
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Vaccine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- hepatitis B vaccination, celiac disease, vaccine non-response, HLA-DQ2, recombinant hepatitis B vaccine, Engerix-B, age at vaccination, revaccination, vaccination strategies
- MeSH terms
- Celiac Disease, Female, Hepatitis Antibodies, HLA-DQ Antigens, Humans, Infant, Male, Retrospective Studies, Vaccination, Vaccines, Synthetic, Hepatitis B Vaccines
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