Low Influenza, Pneumococcal and Diphtheria–Tetanus–Poliomyelitis Vaccine Coverage in Patients with Primary Sjögren’s Syndrome: A Cross-Sectional Study

Abstract

Objective: To evaluate vaccination coverage and reasons for non-vaccination in patients with primary Sjögren's syndrome (pSS). Method: A total of 111 patients fulfilling American-European Consensus Group criteria for pSS were interviewed by use of a standardized questionnaire between January 2016 and November 2017 in two French tertiary referral centers for auto-immune diseases. Results: Updated immunization coverage for influenza was 31.5% (n = 35), pneumococcus was 11.7% (n = 13), and diphtheria-tetanus-poliomyelitis (DTP) was 24.3% (n = 27). The main reasons for non-vaccination were fear of side effects from the influenza vaccine (40.3%) and a lack of proposal for the pneumococcal vaccine (72.3%). In vaccinated patients, vaccination was mainly proposed by general practitioners for the influenza vaccine (42.6%) and rheumatologists for the pneumococcal vaccine (41.2%). Probability of influenza vaccination was associated with age (odds ratio/year (OR) 1.04, 95% confidence interval (CI) 1.0-1.1; p = 0.016), history of severe infection (OR 15.9, 95% CI 1.35-186; p = 0.028), low EULAR Sjögren's syndrome disease activity index (OR 0.85, 95% CI 0.75-0.96; p = 0.013), and comorbidities (OR 3.52, 95% CI 1.22-10.2; p = 0.02). Probability of vaccination against pneumococcus was associated with lung comorbidities (OR 3.83, 95% CI 1.11-13.12; p = 0.033) and up-to-date influenza vaccination (OR 3.71, 95% CI 1.08-12.8; p = 0.038). Conclusion: Influenza, pneumococcal, and DTP vaccine coverage was low in patients with pSS included in this study. These results underline the relevance of systematically screening vaccine status in pSS patients and educating patients and physicians on the need for vaccination to improve vaccine coverage in this population.

Do Not Leave Your Patients in the Dark—Using American College of Rheumatology and European Alliance of Associations for Rheumatology Recommendations for Vaccination in Polish Adult Patients with Autoimmune Inflammatory Rheumatic Diseases

“…Among the main reasons against getting vaccinated, AIIRD patients mentioned, in addition to the lack of knowledge that vaccination is recommended, concerns about potential adverse effects, the exacerbation of rheumatic disease, and lack of concerns regarding contracting illness. This is in line with the literature data that shows the factor mainly affecting vaccination uptake is lack of recommendation by physicians, followed by lack of knowledge that vaccination is required and the fear of their side effects [ 7 , 15 , 18 , 19 , 20 , 22 , 23 , 24 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 40 , 50 ].…”

“…The low vaccination rate among AIIRD patients found in our study is not surprising in this context but fits into the available literature data. The vaccination rate among AIIRD patients varies between different countries and is between 1.5 and 92.4% for influenza vaccines [6,7,, 5.8 and 71.2% for the pneumococcal vaccine [13,[15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]37,38,[41][42][43][44][45][46], 24.3 and 83.7% for tetanus vaccination (booster within 10 years) [26,27,29,33,41,42], and 35.8 and 98.1% for the COVID-19 vaccine (following the recommendations applicable at the time of this study) [6,[40][41][42][43][47][48][49]. An additional problem is the fact that vaccination coverage in Polish AIIRD patients is comparably low as in the general Polish population, even though AIIRD patients constitute a group of particular ...…”

“…The low vaccination rate among AIIRD patients found in our study is not surprising in this context but fits into the available literature data. The vaccination rate among AIIRD patients varies between different countries and is between 1.5 and 92.4% for influenza vaccines [ 6 , 7 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 5.8 and 71.2% for the pneumococcal vaccine [ 13 , 15 , 16 , 17 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ,…”

Vaccination Coverage against Tetanus, Diphtheria, Pertussis and Poliomyelitis and Validity of Self-Reported Vaccination Status in Patients with Multiple Sclerosis

“…In the studies on nationwide vaccination coverage rates, the proportions of people with complete vaccination status were between 5 and 25% higher in eastern German states than in western German federal states [ 34 , 46 , 47 , 48 ]. Studies that have examined vaccinations in patients with other autoimmune diseases report relatively low vaccination completion rates for tetanus, diphtheria, pertussis and poliomyelitis [ 49 , 50 , 51 , 52 , 53 , 54 ]. For instance, in the study by Chehab et al, of the 579 lupus patients examined, 65.8% had a complete vaccination status for tetanus [ 49 ].…”

Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths

“…Adult and at-risk pneumococcal and influenza vaccination data were obtained from [ 5 ] and: Andorra [ 108 ]; Argentina [ 109 , 110 ]; Belgium [ 111 ]; Brazil [ 112 ]; Central and Eastern Europe [ 113 ]; Denmark [ 114 , 115 ]; European nations [ 85 , 116 , 117 , 118 , 119 ]; Europe and Gulf nations [ 120 ]; Germany [ 121 ]; Gulf nations [ 122 , 123 ]; Hong Kong [ 124 ]; Hungary [ 125 ]; Iceland [ 126 ]; Ireland [ 127 ]; Israel [ 128 ]; Latin America [ 129 ]; Mexico [ 130 , 131 ]; New Zealand [ 132 ]; Poland [ 133 ]; Qatar [ 134 ]; San Marino [ 135 ]; Singapore [ 136 ]; Slovenia [ 137 ]; South Africa [ 138 ]; Sweden [ 139 ]; Switzerland [ 140 , 141 , 142 ]; Taiwan [ 143 , 144 , 145 ]; Turkey [ 146 , 147 , 148 ]; and U.K. [ 149 ]. All of these data are summarized in Table 1 .…”