To investigate whether changes in the national Swedish vaccination program coincided with changes in the incidence of CD in infants, Anna Myléus, Ph.D., M.D., from Umeå University in Sweden, and colleagues analyzed data from the National Swedish Childhood Celiac Disease Register and performed a population-based incident case-referent study of infants. Questionnaires and child health clinic records were used to obtain exposure information. The responses to the following vaccines were examined: diphtheria/tetanus, pertussis (acellular), polio (inactivated), Haemophilus influenza type b (conjugated), measles/ mumps/rubella, and live attenuated bacillus Calmette-Guérin (BCG; given to children with increased tuberculosis risk).
The researchers found that the introduction of the pertussis vaccine coincided in time with decreasing CD incidence rates, but there was no association seen between CD and vaccination against pertussis (odds ratio, 0.91; 95 percent confidence interval, 0.60 to 1.4), Haemophilus influenza type b, or measles/mumps/rubella. BCG correlated with decreased risk for CD (adjusted odds ratio, 0.54), but discontinuation of general BCG vaccination had no impact on the cumulative incidence of CD at age 15 years.
"The Swedish epidemic of CD is not fully understood, and changes in the vaccination program or coverage do not contribute to the explanation," the authors write. "We found no epidemiologic evidence that the immunologic response to vaccinations increases CD risk."