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Hepatitis B Vaccine and Boosters Less Effective in People With Celiac Disease

A team of researchers recently took a look at how well the hepatitis B vaccine protected people with celiac disease over time. Specifically, they evaluated what is called long-term antibody persistence and immune memory to hepatitis B virus in adult celiac patients vaccinated as adolescents.

In this photo, hepatitis B attacks cells. Photo: CC--ajc1The research team included F. Zingone, F. Morisco, A. Zanetti, L. Romanò, G. Portella, P. Capone, P. Andreozzi, R. Tortora, and C.Ciacci. They are affiliated with the Department of Clinical and Experimental Medicine of Federico II University of Naples in Italy.

They set out to investigate the anti-HBs antibody persistence and immune memory to hepatitis B virus in adult celiacs vaccinated as adolescents, along with the effects of a booster administration in non-protected individuals.

They found that, eleven years after receiving the initial vaccine dose, the percentage of vaccinees with blood levels ≥ 10 mIU/ml and antibody geometric mean concentrations (GMCs) were lower among celiac patients than among control subjects (68.6% vs 91.7%, p

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Patients with anti-HBs below 10 mIU/ml received a booster dose and were retested after two weeks to measure response levels.

Post-booster anti-HBs levels were still

The study shows that, compared with healthy control subjects, people with celiac disease have lower seroprotective levels of anti-HBs eleven years after main vaccination, in addition to having a substantially lower response rate to a booster dose of the hepatitis B vaccine.

Do you have celiac disease? Have you had a hepatitis B vaccine? Have you had trouble getting proper immunity levels with the hepatitis B vaccine? Is this news to you? Share your comments below.

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11 Responses:

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said this on
03 Apr 2013 5:15:08 AM PST
I work for the USAF in a medical setting. I am required to have Hep B Vaccinations. The first 2 rounds did not take. I was fortunate that the flight doctor was also a friend who okayed me for no more. He said something isn't right, not long after I was diagnosed with celiac disease... Thank you for confirming something I knew to be true!!

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said this on
03 Apr 2013 5:17:49 AM PST
I had to be completely re vaccinated. I will bring this article to my internist and share with him. Perhaps we will even recheck my antibody levels again! I was diagnosed with celiac disease 22 years ago.

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said this on
04 Apr 2013 6:04:15 AM PST
I am now being revaccinated for the third time!!

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said this on
08 Apr 2013 8:06:03 AM PST
This is interesting. My daughter has been vaccinated 3 times (she works in the medical field) and they have not taken. As far as we know she doesn't have celiac disease, but I do. Connection?

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said this on
08 Apr 2013 1:31:52 PM PST
Is this relating to celiacs already on the gluten-free diet or does it relate to untreated disease?

Another Round

said this on
08 Apr 2013 8:03:23 PM PST
Three years ago I tested negative for celiac disease, but then I went on a gluten-free diet anyway because I am sensitive to gluten. I am not immune to Hep B. My 3-shot vaccination as an infant apparently did not take, so I have received an additional 3 vaccinations in the last 12 months as an adult that also have not taken. Blood draws show that I still do not have the Hep B antibody.

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said this on
08 Apr 2013 9:23:04 PM PST
I have celiac disease and have been through 3 rounds of the 3 series hepatitis B shots, and actually had a severe reaction to the last one. I was sure I would have a titre. I do, but it's well below normal levels. However, I was told not to try any more due to the reaction I had.

Camille Pridgen
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said this on
09 Apr 2013 12:41:17 AM PST
My doctor is gluten sensitive, and she did not develop antibodies from the hepatitis B vaccine. My hepatitis B levels were not tested after the vaccination. But I don't produce antibodies to the pneumovax vaccine. I have dermatitis herpetiformis.

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said this on
09 Apr 2013 3:57:27 AM PST
That explains why I had to go two rounds of immunization, and then I had enough antibodies for the entire town! It just seems to make sense. It has to be the autoimmune factor.


said this on
09 Apr 2013 9:30:47 AM PST
My 14 year old daughter was recently diagnosed with celiac disease. After running additional blood work, her HEP B vaccination was found to be nonresponsive. She is scheduled to be revaccinated in the near future as per her doctor.

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said this on
10 Aug 2013 9:27:20 AM PST
So here is our family's history of vaccines and CD and GS: One family member with CD diagnosed 2 years ago contracted rubella (German measles) first year of college (decades ago) despite being complete revaccinated for everything (not just boosters) as a healthcare major. Doctors noted amazement at the time that there was no rubella titer with blood sample. Other three are pretty severely gluten sensitive - though two have not been completely tested for CD as they had low total IgA that could render a false negative with antibody testing, and genetic testing was not done; the other definitely does not have CD but is GS. Several years ago all of us despite being up to date on immunizations and boosters contracted pertussis (whooping cough) . One had to have polio series redone (never developed a titer), and the other had THREE series of Hep B to never develop a titer and the doctors just gave up.

So despite the warnings that CD has severe autoimmune issues - one has to wonder if the immune issues with GS are not as bad/as severe since the autoimmune issues and presentation of symptoms among body systems is so similar between CD and GS. Perhaps much of the ineffectiveness of vaccines in the news the past few years is related to CD and GS, and unless there is a specific reason (such as you are from a foreign country) doctors rarely, if ever, confirm the effectiveness of all these vaccinations by drawing titers/levels of antibodies.

Finally, and this is just my theory (so please do not take this as fact), perhaps the issue with autism is not what is in the vaccines but the autoimmune response these induce in children whose immune systems are altered in some way (CD or GS or other disorder) or are too immature. We know that the inflammatory response of CD and GS has been documented to elicit seizures, migraines, and peripheral neurological issues - so perhaps it in combination with the vaccines triggers autistic syndrome. Perhaps doctors should consider checking IgA levels and performing other screening before immunizing children. It would be great if Dr. Fasano at Mass General looked into this with his study testing the relationship of gluten (reducing/eliminating it) to autistic symptoms.

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