Ask Dr. Weir

Ask Dr. Weir – October 2020

Dr. Dascha Weir

Dr. Dascha Weir

This month’s “Ask the Expert” features Dr. Dascha Weir, MD, Associate Director, The Celiac Disease Program, Boston Children’s Hospital. Dr. Weir answers questions about the flu vaccine and differentiating between COVID-19 and gluten exposure symptoms.

Question – Should patients with celiac disease still get vaccinated for the flu this fall? Is there a risk of this vaccine weakening the immune system toward COVID-19, if exposed? 

Dr. Weir – This year, getting a flu vaccination is more important than ever.  


Influenza, otherwise known as “the flu”, can cause serious life-threating illness in children and adults.  Flu vaccination is the best way to prevent infection and severe influenza related illness. Public health experts are encouraging everyone to get a flu vaccine to help avoid a “twindemic”, an outbreak of both COVID-19 and influenza this season.  


Flu symptoms are very similar to COVID-19 (such as fever, fatigue, cough, difficulty breathing, etc.).  Even with a negative test, it can be difficult to be sure that a symptomatic person doesn’t have a COVID-19 infection. The overlapping symptoms of influenza and COVID-19 can contribute to confusion over the diagnosis.  Preventing flu infection and avoiding this confusion is important. Reducing cases of influenza this year will help to avoid overloading our clinics, hospitals and healthcare systems and may help you and your family avoid isolation/quarantine precautionary protocols. 


With increased mask wearing, hand washing and social distancing, we can all hope for a less severe flu season this year but the best way to ensure protection is vaccination. It is a simple but lifesaving task that will directly protect you, your family and the healthcare system.


There is no evidence that taking a flu vaccine will weaken the immune system to make a COVID-19 infection more likely. 

Question – If my child’s main symptoms of a gluten exposure are vomiting or diarrhea, how do we differentiate if the symptoms are from a gluten exposure or possibly COVID-19? What are good ways to evaluate if we need medical attention or if we should be quarantining with these GI symptoms? 

Dr. Weir – Unfortunately, there is no easy way to tell.  Recent data, from Stanford University, shows that about 30% of adult patients with COVID-19 experience associated gastrointestinal symptoms.  Most of these symptoms were mild but included vomiting and diarrhea.  Importantly, no patients experienced only GI symptoms and none of them had GI symptoms as the first symptom. This means it’s important to look at other symptoms like a fever, cough, or loss of taste and/or smell, among many others, that may accompany the vomiting or diarrhea.  


There is little available data on GI symptoms in children with COVID-19 but if your child is experiencing symptoms, you should reach out to your primary care provider/pediatrician to discuss the potential need for COVID-19 testing. If you think your child has been exposed to gluten or if they have new GI symptoms, please reach out to your gastroenterologist or dietitian. 

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