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Early vaccinations not associated with celiac disease

Clinical Question:
Can celiac disease development in children be linked to vaccinations?

Bottom Line:
Common childhood vaccinations are not linked to the sudden spike in celiac disease diagnoses in Swedish children. (LOE = 2b)

Reference:
Myléus A, Stenlund H, Hernell O, et al. Early vaccinations are not risk factors for celiac disease. 2012;130(1):e63-70.  [PMID:22732174]

Study Design:
Ecologic

Funding:
Government

Setting:
Population-based

Synopsis:
Because of a 4-fold increase in the incidence of celiac disease in Sweden starting in the mid-1980s, followed by an equally abrupt decline 10 years later, these investigators explored changes in the national Swedish vaccination program to find a potential association between vaccination and celiac disease in children. They used 2 approaches: (1) an ecological approach, comparing changes in vaccinations with the celiac disease rate determined by a national registry; and (2) a population-based case-control approach, matching children with biopsy-proven celiac disease with nonaffected children to determine vaccination differences. Neither the introduction of vaccination with pertussis or Haemophilus influenzae type B affected celiac disease rates. Measles/mumps/rubella vaccination was also not related to celiac disease. Polio and diphtheria/tetanus vaccinations were received by almost 100% of infants across the rise and decline of celiac disease. Bacillus Calmette-Guérin (BCG) vaccine in children with increased tuberculosis risk seemed to be protective.

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