“…13,14 However, low rates have also been reported. 15,16 Although awareness of the importance of vaccination for RA patients has grown the potential for certain drugs, such as steroids, MTX and anti-TNF therapy, to reduce the efficacy of the vaccination programme has also been recognised. 17 This underlines the potential value of vaccination early in the disease, although further research on the effect of drugs such as MTX on pneumococcal antibody levels in RA patients are needed to inform the development of optimal vaccination schedules.…”