Kaitlin C. Payne, MD1, Andrew Ford, MD2, Kendra Weekley, MS, RD2, David Gardinier, RD, LD1, Claire Jansson-Knodell, MD2, Alberto Rubio-Tapia, MD1 1Cleveland Clinic Foundation, Cleveland, OH; 2Cleveland Clinic, Cleveland, OH
Introduction: Patients with celiac disease (CD) have an increased risk of pneumococcal infections mainly due to functional asplenia. The 2023 American College of Gastroenterology update on diagnosis and management of CD guidelines suggest pneumococcal vaccination for patients with CD. The frequency of pneumococcal disease vaccination in CD is unknown. The aim of this study was to assess the frequency of pneumococcal disease vaccination in a cohort of adults with CD.
Methods: We performed a retrospective cohort study. We included adult patients with biopsy-proven CD. Data was collected on patient demographics, CD diagnosis, and type of pneumococcal vaccine administered (pneumococcal conjugate vaccine 13 [PCV13], pneumococcal conjugate vaccine 20 [PCV20], pneumococcal polysaccharide vaccine 23 [PPSV23]). “Fully vaccinated” against pneumococcal disease was defined as one dose of PCV20 or one dose of both PCV13 and PPSV23 per CDC guidelines. “Partially vaccinated” were those with at least one dose of PCV13 or PPSV23. Patients with no pneumococcal vaccines were categorized as “unvaccinated.”
Results: We included 340 patients with biopsy-proven CD (mean age 48 years, 75% female, 97% non-Hispanic white), 72 (21%) patients were ≥65 years old. Overall, 141 (42%) had at least one pneumococcal vaccine and 199 (59%) were unvaccinated. Among vaccinated patients, 73 (52%) were “fully vaccinated” and 68 (48%) were “partially vaccinated” [Table 1]. Patients ≥65 were more likely to be fully vaccinated than patients aged 18-64 (56% vs 12%, p< 0.0001). Similarly, patients ≥65 were more likely to be partially vaccinated (74% vs 33%, p< 0.0001). Among 141 patients with at least one pneumococcal vaccine, 100 (71%) received the most recent pneumococcal vaccine in 2017 or later. There was not a trend found on frequency of pneumococcal disease vaccination by year of CD diagnosis.
Discussion: Patients with CD are under-vaccinated against pneumococcal disease, particularly patients < 65 years old. Given the pneumococcal vaccine’s low cost, availability, demonstrated disease reduction in at-risk patients, and high costs of disease burden, gastroenterologists have a responsibility to recognize this gap in CD quality care and work proactively to improve pneumococcal disease vaccination rates in patients with CD.
Disclosures:
Kaitlin Payne indicated no relevant financial relationships.
Andrew Ford indicated no relevant financial relationships.
Kendra Weekley indicated no relevant financial relationships.
David Gardinier indicated no relevant financial relationships.
Claire Jansson-Knodell: ClearPoint Neuro – Stock-publicly held company(excluding mutual/index funds). DarioHealth – Stock-publicly held company(excluding mutual/index funds). DermTech – Stock-publicly held company(excluding mutual/index funds). DiaMedica Therapeutics – Stock-publicly held company(excluding mutual/index funds). Exact Sciences – Stock-publicly held company(excluding mutual/index funds). Inari Medical – Stock-publicly held company(excluding mutual/index funds). Nano-X Imaging – Stock-publicly held company(excluding mutual/index funds). Outset Medical – Stock-publicly held company(excluding mutual/index funds). PavMed – Stock-publicly held company(excluding mutual/index funds). Takeda - AGA Research Scholars Award – Grant/Research Support. Transmedics – Stock-publicly held company(excluding mutual/index funds).
Alberto Rubio-Tapia indicated no relevant financial relationships.
Kaitlin C. Payne, MD1, Andrew Ford, MD2, Kendra Weekley, MS, RD2, David Gardinier, RD, LD1, Claire Jansson-Knodell, MD2, Alberto Rubio-Tapia, MD1. P2633 - Adult Patients With Celiac Disease Are Under-Vaccinated Against Pneumococcal Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
