Can Vaccines Cause Celiac Disease?

No, but having celiac may make the hepatitis B vaccine less effective

Getty Images/Andreas Reh

Some people are concerned that vaccines might somehow trigger or even cause celiac disease. But there's good news: No research has substantiated the idea that vaccines can cause or contribute to celiac or to other autoimmune diseases. In addition, one study is reassuring: it appears that young children who get their regular shots on time are not at any increased risk for celiac disease.

Therefore, you shouldn't hesitate due to celiac disease when your pediatrician says it's time for your child's shots.

In fact, children with malnutrition due to celiac disease might be at risk for more serious cases of infectious diseases, so vaccines may help your child steer clear of that risk.

You also should be aware that actually having celiac disease may make one particular vaccine — the hepatitis B shot — less effective. However, there are steps you can take to counter this risk.

Vaccines, Autoimmune Disease Both Increased At Same Time

The questions surrounding celiac disease and vaccinations center around a timing issue: more kids are being diagnosed with celiac disease these days, and kids are getting more vaccinations, too. So it was plausible to consider whether there was a connection.

Some researchers and parents also had expressed concerns that vaccines could lead to a higher incidence of celiac disease after preliminary research probed the role of vaccines in a related autoimmune disease: type 1 diabetes.

However, several studies and a 2011 report from the Institute of Medicine concluded that vaccines were not to blame for those increases in type 1 diabetes, and research indicates the same is true for celiac disease.

Study Considered Swedish Celiac Disease Epidemic in Infants

The study that addresses this question looked at children in Sweden, where everyone is tracked throughout their lifetimes using a government-sponsored database.

From 1984 to 1996, Sweden experienced what the researchers termed "an epidemic of symptomatic celiac disease among infants" — a rapid, sharp rise in celiac disease diagnoses in infants followed by an equally abrupt decline in diagnoses one decade later.

The cause of this epidemic has been attributed partly to infant feeding practices — in this case, delayed introduction of gluten grains. Early vaccinations were tagged as another possible contributor.

To investigate, the researchers included in the study 392 celiac children who were diagnosed as infants — the median age when symptoms appeared was 11 months, and their median age at diagnosis was 15 months. The study also included 623 children without celiac disease for comparison purposes.

The children had shots for diphtheria/tetanus, pertussis, polio, influenza, measles/mumps/rubella (MMR), and live attenuated bacillus Calmette–Guérin, or BCG (a vaccine against tuberculosis used in some countries with a higher tuberculosis rate, but not used in the U.S.).

The study examined the timing of these shots — some were added to the vaccine schedule during or prior to the start of the "celiac epidemic" — and it examined statistical associations between the vaccines themselves and the incidence of celiac disease in children who received them.

Results: Shots Not Associated with Early-Onset Celiac Disease

No matter how the researchers looked at the data, they concluded that vaccinations didn't cause more children to be diagnosed with celiac disease. "Neither changes over time in the national Swedish vaccination program nor changes in the population's vaccination coverage contributed to explaining the changes in celiac disease incidence rate (i.e., the Swedish celiac disease epidemic)," the study concluded.

In fact, the study suggested a protective effect against early-onset celiac disease for the BCG vaccine, but the researchers cautioned against reading too much into that result.

Celiac Disease May Make Hepatitis B Vaccine Less Effective

Vaccines don't appear to cause early-onset celiac disease, but a handful of studies indicate another possible interaction between celiac and vaccines: people with celiac disease may not respond as well as other people to vaccines for hepatitis B.

The particular gene that predisposes the most people to celiac disease — HLA-DQ2 — also is considered the most important genetic marker indicating a lack of immune system response to the hepatitis B vaccine.

That could indicate many people with celiac disease wouldn't develop immunity to hepatitis B following vaccination, and that appears to be true: in one study, half the people with celiac disease didn't become immune to hepatitis B following a series of three hepatitis B vaccinations. Other studies have found that immunity doesn't persist as long following the hepatitis B shots in people with celiac disease.

This effect may be related to gluten ingestion: in one study, about 26% of those who didn't eat gluten-free, 44% of those who ate gluten-free sporadically, and 61% of those who followed a strict gluten-free diet responded to the hepatitis B vaccine.

Other studies have found that children and adults who follow the gluten-free diet have as strong a response to the hepatitis B vaccine as people without celiac disease. Therefore, in order for this particular vaccine to work as it's supposed to, you shouldn't cheat on the gluten-free diet. You may also want to talk to your doctor about whether you should get your child re-vaccinated for hepatitis B.


Ertem D. et al. The response to hepatitis B vaccine: does it differ in celiac disease?. European Journal of Gastroenterology and Hepatology. 2010 Jul;22(7):787-93.

Hviid A. et al. Childhood vaccination and type 1 diabetes. New England Journal of Medicine. 2004 Apr 1;350(14):1398-404.

Leonardi S. et al. Hepatitis B vaccination failure in celiac disease: is there a need to reassess current immunization strategies? Vaccine. 2009 Oct 9;27(43):6030-3. Epub 2009 Aug 12.

Leonardi S. et al. Vaccination and celiac disease: results of a retrospective study. Minerva Pediatrica. 2011 Oct;63(5):363-7.

Myléus A. et a. Early vaccinations are not risk factors for celiac disease. Pediatrics. 2012 Jul;130(1):e63-70. Epub 2012 Jun 25.

Nemes E. Gluten intake interferes with the humoral immune response to recombinant hepatitis B vaccine in patients with celiac disease. Pediatrics. 2008 Jun;121(6):e1570-6.

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