Background Rheumatology patients with autoimmune inflammatory rheumatic diseases on major DMARDs and/or biologics are at increased risk of infection because of ill-defined immunoregulatory state as well as immunosuppressive drugs. Vaccination against Influenza and Pneumococcus is recommended for such patients1.
Objectives Our ain was to study the awareness and uptake of these vaccines in our rheumatology outpatient cohort on major immunosuppressive drugs and/or biologics.
Methods We audited a total of 60 patients attending our rheumatology outpatient clinics and on major DMARDs (n=29) and/or biologics (n=31). Data collection was done by pre-printed clinical questionnaire during clinic visits. Data was collected on demographics, underlying diagnosis, DMARD/biologics/steroids used, other co-morbid risk factors like Diabetes, chronic lung and heart disease, age over 65 and renal failure, and on awareness and uptake rates of both vaccines.
Results 29 patients were on major DMARDS alone while 31 were on biologics. Although the awareness for vaccination was high at 83%, only 72% had influenza vaccination in the last year and 40% had Pneumococcal vaccination. Even in patients with additional risk factors like Diabetes, chronic lung or heart disease, age over 65 years etc, Pneumococcal vaccination uptake was only 28% compared to 87% for influenza vaccine. The main reasons for low uptake of pneumococcal vaccine were non-availability of Pneumovax for such patients at general practice and patient refusal due to previous reaction.
Conclusions There is good uptake of Influenza vaccine in our rheumatology cohort on major DMARDs/Biologics. The uptake of pneumococccal vaccine is sub-optimal even in those immunosuppressed patients with additional risk factors. Raising awareness about the importance and safety of such vaccinations amongst patients and local general practitioners and improving availability of such vaccines at primary care level is of paramount importance to help reduce recurrent serious infections and hospitalisations.
van Assen, S;Agmon-Levin, N et al EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseasesAnn Rheum Dis 2011;70:414-422 doi:10.1136/ard.2010.137216
Disclosure of Interest None Declared
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