Ask Dr. Weir – January 2021
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 about vaccines and teens transitioning to caring for themselves.
Question – Are there any considerations for vaccines or other well-child milestones that should be considered differently for a child with celiac disease?
Dr. Weir – Once a child with celiac disease has been diagnosed and treated with a gluten-free diet, we expect that they will be on track with their development and hit age-appropriate milestones like other children without celiac disease. Every child should see their pediatrician regularly for age-appropriate anticipatory guidance, preventative care and monitoring of growth and development.
Children with celiac disease should be on the same vaccination schedule as other children. We also encourage annual influenza vaccination. However, many children with celiac disease appear to have diminished response to the initial Hepatitis B vaccination series. For this reason, we recommend a check of Hepatitis B titers to assess for adequate antibody response and recommend revaccination as needed.
As we discussed in last months “Ask the Expert”, it is important for children to maintain a connection with a gastrointestinal specialist and to see them regularly for more celiac related care.
Question – As teens turn into adults, what should they know about monitoring their celiac disease?
Dr. Weir – As children get older, they typically begin to take charge of their gluten-free diet. The process of building skill sets to stay safely gluten-free takes time and varies between individuals. It may start by reading labels while at a friend’s house or asking questions in a restaurant instead of their parents. By the time a teenager is headed to college, they should be able to navigate the campus cafeteria and be able to plan a safe food experience for a trip away with friends.
Along the way, teenagers with celiac disease should also start taking over other aspects of their celiac disease related care. At follow-up visits with their GI specialist, they should be interacting directly with their care team by giving updates and asking questions. If they take medications or supplements, they should know what they take and why. Eventually, they should assume control over scheduling follow-up appointments. When they become adults, they will be ready to transition to an adult celiac specialist for annual visits.