Potential determinants of vaccine hesitancy among celiac disease patients: a single cohort analysis

Vaccine Efficacy and Safety in Patients with Celiac Disease

Celiac disease (CD) is an autoimmune disorder caused by gluten intake in genetically predisposed individuals. This article provides an overview of the available data on the risks of infectious diseases and the mechanisms involved in CD, including a detailed analysis of vaccine efficacy, immunogenicity, and safety. The published articles were retrieved from the PubMed database using the terms "celiac disease", "efficacy", "hyposplenism", "immune response", "infections", "immunization", "immunogenicity", "safety", "vaccination", and "vaccine". CD can be associated with several autoimmune diseases, including selective immunoglobulin A deficiency (SIgAD), altered mucosal permeability, and hyposplenism. These conditions entail an increased risk of infections, which can be prevented by targeted vaccinations, although specific recommendations on immunization practices for subjects with CD have not been released. Regarding vaccinations, the immune response to the Hepatitis B virus (HBV) vaccine can be impaired in patients with CD; therefore, proposed strategies to elicit and maintain protective specific antibody titers are summarized. For patients with conditions that put them at risk of infections, vaccinations against Pneumococcus and other encapsulated bacteria should be recommended. Based on the available evidence, the Rotavirus vaccine offered to children could be useful in preventing CD in at-risk subjects. Overall, except for the HBV vaccine, vaccine efficacy in patients with CD is comparable to that in the general population, and no safety concerns have arisen.

SARS-CoV-2 Vaccination Coverage in Italian Children with Celiac Disease

Background: Celiac disease (CD) is the most common multisystemic autoimmune disorder affecting the pediatric population. However, little data is available regarding SARS-CoV-2 vaccination coverage in pediatric patients with CD. This study aims to evaluate the adherence to national recommendations for SARS-CoV-2 vaccination in children and adolescents with CD and its variation over time. Methods: We retrospectively analyzed medical charts and electronic registry records of SARS-CoV-2 vaccination of patients aged 0-19 years diagnosed with CD in a tertiary center. The vaccination coverage was evaluated according to age groups (young children, children, and adolescents), considering the patients' eligibility for vaccination at different times. Results: Among the 172 patients enrolled, 44.8% received at least one dose of the SARS-CoV-2 vaccine, showing no significant differences compared to the Italian population of similar age. Vaccination coverage demonstrated a progressive reduction after an initial peak (up to 65.5% in December 2021) concomitant with a gradual extension of vaccinable eligibility and falling SARS-CoV-2 infections. Histological diagnosis and the presence of other associated autoimmune diseases were associated with higher levels of adherence to vaccination. Conclusions: Adherence to the SARS-CoV-2 vaccination in young Italian children with CD was very low, while it was better in adolescents and patients with other associated autoimmune diseases. Vaccine hesitancy remains a concern, particularly among those diagnosed using the biopsy-sparing approach. Hesitancy increased during the pandemic period, suggesting the need for ongoing efforts to improve adherence to SARS-CoV-2 vaccination recommendations.

Psychological dynamics of pandemic resilience: a tale of two cultures

The present work endeavours to explore the experiences of university-level students from Pakistan and Nepal after the COVID-19 outbreak. A comprehensive electronic survey was carried out utilising a meticulous cluster sampling technique encompassing two distinct populations, i.e. Pakistan and Nepal, during the period extending from September 2022 to January 2023. A total of 2496 participants completed the questionnaire (Pakistani population: 55.45% and Nepalese population: 44.55%). We utilised the Mental Health Continuum-Short Form (MHC-SF), Pittsburgh Sleep Quality Index (PSQI), feeling of loneliness (UCLA), interdependent happy scale (IHS), and fear of COVID-19 scale (FCV-19S). Notably, a significant intercultural disparity was observed, particularly concerning the level of COVID-19 fear which was higher among the Nepalese population. However, this particular variable did not demonstrate any significant associations with other variables, except for the social dimension of MHC-SF. There was a negative correlation observed between this variable and IHS within the Pakistani population. Irrespective of the varying degrees of apprehension towards COVID-19 within the two distinct cultural contexts, there exists a significant positive correlation between the assessed psychological assets and individual well-being, as well as the resumption of regular activities after the outbreak.