1 in 5 Patients with Rheumatoid Arthritis Not Vaccinated Against Flu

One in 5 patients with rheumatoid arthritis (RA) received no influenza vaccination, and 1 in 2 received no pneumonia vaccination in a recent study of over 15,000 patients.

Patients with RA are more susceptible to infections, and, therefore, guidelines recommend vaccination for protection against infections like influenza and pneumonia. Despite this, levels of adherence to these guidelines are not well known.
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For their retrospective cohort study, the researchers analyzed data from a large primary care database on 15,724 adults diagnosed with incident RA and treated with non-biologic immunosuppressive therapy in the United Kingdom.

Patients were considered unvaccinated with the influenza vaccine on September 1 of each year, and upon vaccination, were considered vaccinated. For the pneumococcal vaccine, patients were considered vaccinated after their first vaccination until the end of follow-up.

Overall, 80% of patients received at least 1 influenza vaccination, and 50% received at least 1 pneumococcal vaccination. Of patients aged 65 or younger, 73% had received at least 1 influenza vaccination and 43% received at least 1 pneumococcal vaccination. Ninety-one percent of those aged over 65 years received at least 1 influenza vaccination and 61% received at least 1 pneumococcal vaccination. Patients who were vaccinated were older, had more comorbidity, and more frequently visited their doctor.

“In conclusion, despite international recommendations, this study has found that many patients with RA in the UK are not being immunized regularly for influenza, and often not at all for pneumonia. Many patients are not being immunized prior to starting [disease-modifying anti-rheumatic drug] therapy. The patients most often being missed are those who are below 65 years of age and who do not have another disease for which vaccination is recommended.”

—Michael Potts

Reference:
Costello R, Winthrop KL, Pye SR, Brown B, Dixon WG. Influenza and pneumococcal vaccination uptake in patients with rheumatoid arthritis treated with immunosuppressive therapy in the UK: A retrospective cohort study using data from the clinical practice research datalink [published April 20, 2016]. PLOS One. http://dx.doi.org/10.1371/journal.pone.0153848.