Background The EULAR recommendations for vaccination in adult patients with autoimmune rheumatic diseases strongly recommend inactivated influenza vaccination.Insufficient data are available about safety and efficacy of meningococcal C vaccination.In 2015–2016,after an increased incidence of meningitidis C infections in our country,the health care system has promoted a free meningococcal vaccination campaign
Objectives To evaluate the adherence to the EULAR recommendations for influenza vaccination and to the meningococcal C vaccination campaign in a cohort of patients with autoimmune rheumatic diseases and to assess their safety.The efficacy in term of immune response to meningococcal C vaccination has been also evaluated
Methods Consecutive in- and out-patients seen at our unit from February to December 2016 were enrolled in the study.Using a questionnaire created ad hoc the following data were collected:the percentage of patients who underwent influenza and/or meningococcal C vaccinations in the previous 12 months,the occurrence of adverse events and of disease flares after vaccinations,according with the report from the patients and with the rheumatologist clinical evaluation.Seroconvertion rates in patients and healthy controls were assessed using ELISA kits for human anti-meningococcal ACWY IgG antibodies.Antibody titres were expressed in U/ml and according with kit reference value were classified in absent,low,medium and high titre
Results 286 patients (91% female) (143 SLE, 68 RA,60 Scleroderma,11 Sjögren Syndrome,3 Behcet disease and 1 Dermatomyositis) were included in the analysis.The mean age at evaluation was 52.9±16.1 years,mean disease duration was 15.3±10 years.The 53.1% of patients was taking steroids,at an average dose of 4.2 mg of 6-metilprednisolone/day,134/286 (46.9%) patients were on immunosuppressive therapies,of which 49/134 (36.6%) on biologic agents.The 19.9% (57/286) of patients underwent influenza vaccinations and the 13.3% (38/286) meningococcal C vaccination,8 patients underwent both vaccinations.No disease flares were observed after vaccination;seven patients reported non-specific adverse events after influenza (fever,discomfort,nausea,arthralgia) and 2 patients after meningococcal C vaccination (fever,rash at the injection site,discomfort).Seroconversion after meningococcal vaccination was analysed in 27 patients and 9 healthy subjects,no statistically significant differences in terms of antibody response to meningococcal vaccination were observed between these two groups.Treatment (steroids and immunosuppressive drugs) did not influence antibody titres
Conclusions These data highlight the poor adherence to international recommendations on influenza vaccination in patients with autoimmune rheumatic disease at our Unit.The adherence to the meningococcal C vaccination campaign conducted in our country in 2015–2016 was also low.Our data confirm the safety of these vaccination and show that the immune response elicited by meningococcal C vaccination is comparable to healthy controls and is not influence by therapy
van Assen S, Agmon-Levin N, Elkayam O, et al.EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases.Annals of the rheumatic diseases 2011; 70(3): 414–22.
Disclosure of Interest None declared