Celiac disease (CeD) is a condition where the immune system is triggered by consuming gluten, leading to damage in the small intestine. Those with the disease are more likely to develop other autoimmune disorders. While people often wonder if patients with CeD respond differently to vaccines, they receive the same benefits from vaccines as the general population, apart from the hepatitis B vaccine.  

During the COVID-19 pandemic, concerns were raised about whether people with CeD would have a strong enough immune response to the vaccines. This is because previous research has shown that the hepatitis B vaccine was less effective in children with CeD. Studies have also shown that individuals with well-managed CeD on a gluten-free diet do not experience this problem. Additionally, the absence of data from COVID-19 vaccine clinical trials involving individuals with CeD heightened these concerns.  

A recent international study done by Maccabi KSM Research in Israel, published in the journal Viruses and featured in Cision PR Newswire, aimed to assess the effectiveness of the Pfizer COVID-19 vaccine in patients with CeD.  

Dr. Benjamin Lebwohl, MD, MS – a gastroenterologist at Columbia University Irving Medical Center in New York City and recipient of a Celiac Disease Foundation grant award – was a study co-author. “We did this study as a response to concerns that vaccines are sometimes less effective in people with celiac disease. This appears to be the case for hepatitis B, for example,” he said. 

How did they do it? 

Researchers used the Maccabi Healthcare Services comprehensive database, a 2.5-million-member state-mandated health fund in Israel, to perform a retrospective cohort study. The study used vaccinated patients aged 12 and up with CeD with at least two Pfizer COVID-19 vaccine doses. Patients were required to have had their second dose of the vaccine a minimum of 14 days (2 weeks) prior to ensure full vaccine effectiveness. The analysis used 5,381 patients with CeD and 14,939 controls, and it excluded patients with a record of a prior positive polymerase reaction (PCR) result or those with a diagnosis of SARS-CoV-2 prior to the index date. The CeD patient group was separated into four categories, including those with well-controlled CeD, uncontrolled CeD, possibly not controlled CeD, and newly diagnosed patients.  

What did they find? 

The study results revealed that the Pfizer COVID-19 vaccine offers the same level of protection against the virus for patients with CeD as it does for those without the autoimmune disease. The effectiveness of the vaccine was consistent among all four groups. Patients with controlled or uncontrolled CeD, as well as those with newly diagnosed CeD, showed no significant difference in response to the vaccine. 

What does this mean? What does this change? 

Vaccinations play an important role in controlling infectious diseases by helping the immune system fight infections faster and more efficiently, working with the body’s defenses to reduce disease risks. Many groups were not included in initial clinical trials for the COVID-19 vaccines, and studies such as this help decrease the gap in data, lessening the concern of lack of protection for individuals with CeD. Dr. Lebwohl noted, “We were reassured to find that in the case of COVID, vaccination is similarly effective in people with celiac disease compared to the general population. With the introduction of potentially life-saving vaccines, it is important to study their effectiveness in people with celiac disease, and this study is one such opportunity.” 

Keep reading to learn more about the study. 

Your experience with celiac disease is critical to ongoing disease research efforts. Add your data to our iCureCeliac® patient registry today. iCureCeliac® is the Foundation’s patient-powered tool that is the single best resource for celiac disease researchers around the world helping to accelerate the search for treatments and a cure. iCureCeliac® has powered numerous research studies about celiac disease and is the key contributor of patients to a number of critical clinical trials for celiac disease drugs.