Pneumococcal antibody protection in patients with autoimmune inflammatory rheumatic diseases with varying vaccination status

Rasmussen, S L; Fuursted, Kurt; Nielsen, KN; Laurberg, N P; Sørensen, M.; Fagerberg, Steen Kåre; Leutscher, Peter Derek Christian; Rasmussen, Claus

doi:10.1080/03009742.2020.1732459

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…Patients with multiorgan involvement diseases and treated with corticosteroid and other immunosuppressive therapies need special attention to prevent infections [11] and to plan early therapy intervention [12]. The higher prevalence of infections and the higher risk of mortality, hospitalization, and complications for SSc patients, make the antiflu and antipneumococcal infection vaccination particularly crucial [13,14].…”

Section: Introduction 1infections and Systemic Sclerosismentioning

confidence: 99%

Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

et al. 2021

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Systemic sclerosis (scleroderma, SSc) is an autoimmune connective tissue disease characterized by excessive production of collagen and multiorgan involvement. Scleroderma patients are at increased risk of influenza complications and pneumonia; thus, vaccinations are recommended. This systematic review evaluated the influenza and pneumococcus vaccination coverage for SSc patients. We included all studies from Pubmed reporting on influenza and pneumococcal vaccination rate in Scleroderma patients up to May 2021. The 14 studies thus selected identified a suboptimal vaccination rate in autoimmune and SSc patients, ranging from 28 to 59% for the flu vaccine, and from 11 to 58% for the pneumo vaccine in absence of specific vaccination campaigns, variously considering also other variables such as age, gender, vaccination settings, and possible vaccination campaigns. We also considered the reasons for low coverage and the approaches that might increase the vaccination rates. A lack of knowledge about the importance of vaccination in these patients and their doctors underlined the need to increase the awareness for vaccination in this patients’ category. Current guidelines recommend vaccination in elderly people and people affected by particular conditions that widely overlap with SSc, yet autoimmune diseases are not always clearly mentioned. Improving this suboptimal vaccination rate with clear guidelines is crucial for SSc patients and for clinicians to immunize these categories based principally on the pathology, prior to the age. Recommendations by the immunologist and the direct link to the vaccine providers can highly improve the vaccine coverage.

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Section: Introduction 1infections and Systemic Sclerosismentioning

confidence: 99%

Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

et al. 2021

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“…Haberman et al even found a strongly decreased anti-SARS-CoV-2 seroconversion rate of 62.2% in patients with immune-mediated inflammatory diseases receiving MTX (59). This negative effect of MTX on seroconversion rates is also known from other types of vaccines such as influenza, pneumococcal or tetanus (60)(61)(62)(63)(64)(65).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

et al. 2023

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BackgroundThe rate of seroconversion after COVID-19 vaccination in patients with moderate to severe psoriasis requiring systemic treatment is poorly understood.ObjectivesThe aim of this prospective single-center cohort study performed between May 2020 and October 2021 was to determine the rate of seroconversion after COVID-19 vaccination in patients under active systemic treatment for moderate to severe psoriasis.MethodsInclusion criteria were systemic treatment for moderate to severe psoriasis, known COVID-19 vaccination status, and repetitive anti-SARS-CoV-2-S IgG serum quantification. The primary outcome was the rate of anti-SARS-CoV-2-S IgG seroconversion after complete COVID-19 vaccination.Results77 patients with a median age of 55.9 years undergoing systemic treatment for moderate to severe psoriasis were included. The majority of patients received interleukin- (n=50, 64.9%) or tumor necrosis factor (TNF)-α inhibitors (n=16, 20.8%) as systemic treatment for psoriasis; nine patients (11.7%) were treated with methotrexate (MTX) monotherapy, and one patient each received dimethyl fumarate (1.3%), respectively apremilast (1.3%). All included patients completed COVID-19 vaccination with two doses over the course of the study. Serum testing revealed that 74 patients (96.1%) showed an anti-SARS-CoV-2-S IgG seroconversion. While all patients on IL-17A, -12 or -12/23 inhibitors (n=50) achieved seroconversion, three of 16 patients (18.8%) receiving MTX and/or a TNF-α inhibitor as main anti-psoriatic treatment did not. At follow-up, none of the patients had developed symptomatic COVID-19 or died from COVID-19.ConclusionsAnti-SARS-CoV-2-S IgG seroconversion rates following COVID-19 vaccination in psoriasis patients under systemic treatment were high. An impaired serological response, however, was observed in patients receiving MTX and/or TNF-α inhibitors, in particular infliximab.

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“…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 ...…”

Section: Discussionmentioning

confidence: 99%

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

Wroński,

Palej,

Stańczyk

et al. 2023

Vaccines

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(1) Introduction: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) face a higher infectious risk compared to the general population. As per the ACR and EULAR recommendations, vaccinations against influenza, COVID-19, pneumococci, and tetanus are recommended for most patients with AIIRD. (2) Objectives: This study aimed to assess vaccination coverage among Polish AIIRD patients and identify factors influencing it. (3) Patients and Methods: This study was conducted at the reference rheumatological center in Poland between May 2023 and October 2023. The study participants completed a questionnaire covering their knowledge of vaccination recommendations, actual vaccination status, factors affecting their decision to vaccinate, and their perspectives on immunization. (4) Results: This study involved 300 AIIRD patients and 60 controls. Both groups exhibited comparably low vaccination rates for all diseases (the highest for COVID-19—52% in both groups and the lowest for pneumococci—7.7% and 10%, respectively). Knowledge about recommended vaccinations was limited among patients in both groups. AIIRD patients were also not aware that they should avoid live vaccines. The primary motivators for vaccination among AIIRD patients were fear of infection (up to 75%) and medical advice (up to 74.6%). Conversely, the predominant reasons for non-vaccination were a lack of knowledge that vaccination is recommended (up to 74.7%) and concerns about potential adverse effects (up to 48.6%). Many patients reported not receiving vaccination recommendations from either primary care physicians or rheumatologists. (5) Conclusions: To enhance vaccination coverage among AIIRD patients in Poland, it is essential to educate them about vaccinations during routine medical consultations, emphasizing the increased risk of infection, informing them about recommended vaccinations, and clarifying doubts about adverse effects.

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Pneumococcal antibody protection in patients with autoimmune inflammatory rheumatic diseases with varying vaccination status

Cited by 13 publications

References 21 publications

Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

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

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