Coeliac disease on its own is not listed by the Government as an underlying health condition. Problems with your spleen (eg hyposplenism) is listed though. Around 30% of people with coeliac disease have reduced spleen function, known as hyposplenism, which affects the body’s ability to fight infection. Because this isn’t routinely assessed, not everyone will know if they have reduced spleen function. As a precaution, our Health Advisory Council think it is reasonable that people with coeliac disease may consider themselves to be within the at risk group for coronavirus and to follow the associated advice.

Everyone is advised to apply social distancing but people who have problems with their spleen are advised to be particularly stringent. Research tells us that 30% of people with coeliac disease also have hyposplenism which affects the body’s ability to fight infection. But, because hyposplenism isn’t routinely assessed, not everyone will know if they have reduced spleen function or if they’re in the 70% of people that don’t have hyposplenism. As a precaution our Health Advisory Council think it is reasonable that people with coeliac disease may consider themselves to be within the at risk group and to follow the associated advice.

The government has provided advice on shielding for people defined as extremely vulnerable from COVID-19. People with coeliac disease (including those who have problems with their spleen) who have no other health conditions do not fall into this category. If you fall into this category you should receive a letter by Sunday 29 March 2020. The Government website has more information on shielding.

For children with coeliac disease the risk of hyposplenism seems to be very low. We don’t really know for sure what the numbers are. Even testing for hyposplenism and determining the true effect it has, is difficult in practise. My own experience over 20 years of running a service for under 16s, is that I haven’t seen one case of pneumococcal infection in our patient group, and I have not seen any patients hospitalised for this, despite them having the usual coughs and colds.

We’re doing our bit too, and we have furloughed all the staff we can (1 in 3), without damaging the services we provide. We have cancelled or postponed some activities until after the crisis to cut costs as much as possible.

If you live in England and you are vulnerable it is really important to register on the government website. This is the database that is being shared with supermarkets to allow them to prioritise delivery slots and other help for you.

If you live in Wales, Scotland or N. Ireland there is a different process. For more information please read here.

If you are not vulnerable and are able to leave your house providing you are in a position to, we would encourage you to shop in store so that online delivery slots can be given to those who need them most.

Some adults (but very few children) with coeliac disease will have reduced spleen function (also called hyposplenism or splenic dysfunction). This means that the spleen might not be functioning as well as it should but doesn’t definitely mean that it isn’t working at all. The spleen is an organ in the body which plays an important role in the immune system, controls the level of blood cells and filters the blood to remove old or damaged red blood cells. It also has a specific immune function in helping to protect us against a small number of bacterial infections such as pneumonia.

There doesn’t seem to be an increased risk of viral infection if someone has hyposplenism, but there is a small risk of having a “secondary bacterial infection” which is when you have an additional infection such as pneumonia during or after another infection, like a virus.

Excellent and safe vaccines are available against bacteria for people who do not have a functioning spleen. Many people have these vaccinations routinely – for instance pneumococcus vaccination is given during the childhood immunisation programme and any elderly that missed out when young (see specific section on pneumococcal vaccination). Similarly, we recommend that all adult patients with coeliac disease receive these vaccinations – if they have not already had them.

Children are offered the pneumococcal vaccination as part of the childhood immunisation programme and it was introduced in 2006. All who have had this are as protected as they can be and there are no other immunisations we can give that add any extra protection to what you already have.

Adults with coeliac disease may not have had the vaccine during childhood, or after their coeliac disease diagnosis. If they haven’t, they are advised to speak with their GPs and arrange a vaccination at a convenient time. Clearly we are in difficult times, and the priority for now is reducing your risk of getting Coronavirus in the first place. That is the priority for all of us. GPs and their teams are going to be overwhelmed with enquiries and may not be able to arrange pneumococcal vaccinations quickly for you. In reality, even if you have not had the vaccination, your risk of developing a pneumococcal infection is low. Most patients as far as we can tell, will only ever need one dose of vaccination against pneumococcal disease and that is in the current government immunisation advice. The vaccine is called PPV23.

The current schedule (it is changing for babies in 2020) and who is eligible is linked here.

One concern for coronavirus and people who may have hyposplenism or who are not immunised against pneumococcus is the possible risk of a secondary bacterial infection, such as developing bacterial pneumonia after or while you have coronavirus. As I have said, the majority of people with coeliac disease do not have hyposplenism and although pneumococcal vaccination helps to protect against pneumococcus, even if you have not yet had it, your risk will be low. Please see the above section on Pneumococcal vaccination.

If you or your child have had all the routine childhood immunisations, then you are as protected as I think you can be. You should still follow the current practical government guidelines on hand washing, self-isolation (if it is relevant to you) and social distancing, which apply to all of us. This will reduce your risk and that to other people.

If you are an adult or a teenager who didn’t have pneumococcal vaccination as part of your childhood immunisations then you should speak with your GP about having this vaccination, called PPV23. Even if you are not able to get it due to the current crisis, if you stay safe, wash your hands regularly and follow all the government advice you will keep your risk as low as it can be.