Vaccination survey in patients with rheumatoid arthritis: a cross-sectional study

Abstract

The objective of this study is to evaluate the vaccination status in rheumatoid arthritis (RA) patients during routine clinical practice, data from a German non-interventional cross-sectional study. In this prospective study, patients with rheumatoid arthritis were interviewed using a standardized questionnaire focusing on vaccination. Available vaccination documents were evaluated, and titers for common vaccination antigens (hepatitis B, rubella, mumps, measles, diphtheria, tetanus) were analyzed with special regard to the underlying treatment and age of patients. A total of 301 RA patients treated with conventional DMARDs alone (cohort I, n = 125), TNF-blocking agents (cohort II, n = 117), or B-cell depletion with rituximab (cohort III, n = 59) have been studied. Significantly more patients in the biologic cohorts II and III were aware of an increased risk of infections (I: 67.7%, II: 83.8%*, III: 89.9%*, P < 0.05). Pneumococcal vaccination rate was significantly higher (I: 20.2%, II 36.8%* and III: 39.0%*, P < 0.05) compared with cohort I. Differences were less evident for influenza. Significantly more patients ≥60 years of age have been vaccinated against Streptococcus pneumoniae and influenza. An obvious discrepancy existed between vaccination awareness and actual vaccination rates for all cohorts. No significant differences in vaccination titers could be seen between the three cohorts. Awareness of infectious complications was more present in patients treated with biologicals, and also, the rate of patients vaccinated against Streptococcus pneumoniae increased significantly depending on the underlying treatment. Nevertheless, there was a discrepancy between vaccination awareness and actual vaccination rates for all cohorts.

Influenza and pneumococcal vaccination in patients with rheumatoid arthritis in comparison with age- and sex-matched controls: results of a claims data analysis

“…Because only RA patients in rheumatologic care were included in COMORA, our study confirms this vaccination coverage. The proportion of vaccinated RA patients was, both in COMORA and PROCLAIR, considerably lower than in the second study, where 301 patients were included in a single centre and the reported vaccination rates were between 20.2 and 39.0 % (pneumococcal) and 59.3 and 69.2 % (influenza) for different treatment arms [14]. The higher rates may be explained by higher vaccination awareness in the hospital or within the region.…”

“…Our study calculated overall vaccination rates of 15.0 % (pneumonia) and 40.8 % (influenza). Two studies have examined the vaccination coverage of subgroups in Germany [14,15]. COMORA studied the vaccination coverage in 3920 RA patients, among them 209 German patients [15].…”

“…It remains unclear if vaccination is performed sufficiently in routine care. Available data for Germany are limited to two small samples with 301 and 209 patients in rheumatologic care [14,15].…”

Vacinação em pacientes da Coorte Brasília de artrite reumatoide inicial

“…[22][23][24][25] Não observamos influência da orientação sobre o uso de nenhuma vacina. Entretanto, Doe S et al mostraram melhora da taxa de vacinação contra gripe após otimização da orientação por parte dos profissionais de saúde, com aumento de 56% para 72% em quatro anos de observação.…”

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

“…The awareness of the possibility to prevent influenza infections and invasive pneumococcal disease by vaccination and the number of effectively performed vaccinations vary within the group of RA patients [6,11].…”