University of Manchester researchers investigating how closely rheumatoid arthritis (RA) patients adhere to influenza and pneumococcal vaccination guidelines, found only suboptimal compliance — a factor that greatly contributes to their high risk of contracting such infections.
The study, “Influenza and Pneumococcal Vaccination Uptake in Patients with Rheumatoid Arthritis Treated with Immunosuppressive Therapy in the UK: A Retrospective Cohort Study Using Data from the Clinical Practice Research Datalink,” was published in PLOS ONE.
RA patients are at considerable risk of infections due to reasons that range from the disease itself to comorbidities and immuno-suppressive treatment. As such, guidelines recommend they receive vaccinations to protect against infections, namely pneumonia and influenza. Previous studies have shown that influenza and pneumococcal vaccinations elicit an antibody response despite the immunosuppressive therapy, and are safe for RA patients.
Researchers looked into the vaccination record for this specific high-risk patient group, although little data is readily available.
“There is no national data on vaccination uptake broken down in a way that allows us to pull out those with RA. Only one study in the US has looked at whether patients with rheumatic diseases are being vaccinated prior to starting immunosuppressive therapy,” Dr. Will Dixon, who led the study, said in a press release.
The scientists analysed data from 15,724 patients diagnosed with RA between 2000 and 2013, obtained in the Clinical Practice Research Datalink (CPRD). According to the results, during follow-up (mean 5.3 years), only 805 of the patients had received at least one influenza vaccination, and only 50 percent — or 1 in every 2 — had a pneumococcal vaccination. In those under age 65 (a total of 9,969 patients) 73 percent had received at least one influenza vaccination, and 43 percent had at least one pneumococcal vaccination; these numbers poorly compared with patients over 65, whose vaccination numbers amounted to 91 percent and 61 percent, respectively. The results indicated that younger patients either visited their GP less often, or were less likely to be vaccinated against such infections. “One in five patients received no influenza vaccinations and one in two patients received no pneumonia vaccine over five years of follow-up” the researchers wrote.
“Guidance on influenza and pneumococcal vaccination for RA patients is unclear, and payment to carry it out in primary care is variable,” said Dr. Ben Brown, a study author. “In future it may be beneficial for rheumatologists to provide GPs with specific advice about appropriate vaccination for individual patients, or to consider administering the vaccinations themselves in their own clinics — either way, both approaches should be adequately funded.”