Background Current guidelines recommend immunization in patients with autoimmune diseases and use of immunosuppressants including biological treatment. Despite the above, the frequency of immunization is unknown in our population.

Objectives To identify the prevalence of immunization in patients with autoimmune disease in a Rheumatology Service of a third level hospital in Mexico.

Methods Observational, descriptive, cross-sectional study. Consecutive outpatients with autoimmune diseases who attended the Rheumatology Service of the Hospital Civil of Guadalajara during a period of 2 months (Dec. and Jan.) were included. A questionnaire was carried out to obtain demographic and immunization data. Descriptive statistical analysis was performed.

Results 1208 patients were surveyed, 484 (40%) had a diagnosis of autoimmune disease; of whom 286 (59%) were on immunosuppressant therapy. 321 patients had a complete immunization during childhood. None of the patients knew what vaccines should by received with their diagnosis. When asked if they had been invited for immunization and from whom, 24 reported that their general practitioner, 126 immunization campaign, 19 nurse, 9 rheumatologist, 4 pulmonologist, 1 infectious disease specialist, 1 family doctor and 1 internist. 260 (54%) reported having their immunization records. Only 37 had been vaccinated with influenza, 27 pneumococcus, 4 human papilloma virus and 2 Hepatitis B in the past. 372 (77%) accepted the invitation to be vaccinated on the day of their interview, but only 72 (19%) went to get the immunization; 41 of whom were given anti-influenza vaccines and 34 Pneumococcus (PPSV 23). The main causes for which the patient considers not to be vaccinated are: 85% “Because my treating doctor has not recommended me to go get vaccinated”, 36% “They often do not have the vaccine to apply”, 36% “I forget to get the vaccine on time”, 31% “I think the application of the vaccine can make me sick”, 14% “A vaccination center is not accessible”, 7% “I think it is not useful to get vaccinated”, and 5% “My doctor recommended me not to get vaccinated”. These patients presented a total of 172 recurrent infections that included: upper airway infection 55, pneumonia 4 and others; 90 hospitalizations were required due to infection of which the main were due to: pneumonia 29, pulmonary tuberculosis 4, kidney 3, bone 1 and meningitis 1.

Conclusions Immunization in this group of patients is low and rarely accepted mainly because their rheumatologist does not provide them with this information and due in general to a lack of information. This action is extremely important as it might reduce some serious infectious processes that lead to hospitalizations and increase the mortality in these immunosuppressed patients.

References

1. Singh Jec. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis and Rheumatology. 2015;: p. 1–26.

2. Zimmerman Rec. Barriers and facilitators of pneumococcal vaccination among the elderly. Vaccine. 2003;: p. 1510–1517.

3. Cardiel Mec. Actualizaciόn de la Guía Mexicana para el Tratamiento Farmacolόgico de la Artritis Reumatoide del Colegio Mexicano de Reumatología. Reumatología Clínica. 2013;: p. 1–14.

References

Disclosure of Interest None declared