Pneumococcal and influenza vaccination coverage in patients with inflammatory rheumatic diseases receiving immunosuppressive therapy and annual nurse-led education.

OBJECTIVES

Vaccination rates among patients with RA or SpA remain suboptimal. This study examined the uptake of pneumococcal and influenza vaccines among patients undergoing immunosuppressive therapy and receiving annual nurse-led education.

METHODS

Patients with RA or SpA who initiated their first biologic therapy between 2015 and 2017 and attended yearly visits with a rheumatologist and a therapeutic patient education (TPE) nurse over 5 years were included. Adherence to pneumococcal and influenza vaccine recommendations and factors associated with vaccine uptake were assessed.

RESULTS

A total of 156 patients were analysed: 60 RA and 96 SpA. Overall, 81% (95% CI 74, 87) adhered to the 5-year pneumococcal vaccination recommendations (82% in RA and 80% in SpA). Among patients with RA, a history of major adverse cardiac events or deep vein thrombosis/pulmonary embolism at baseline and the occurrence of myocardial infarction or stent placement during follow-up were associated with non-adherence. Among patients with SpA, those who experienced infections during follow-up were more likely to adhere to the pneumococcal vaccination recommendations. Between 2015 and 2022, influenza vaccination rates increased from 63% to 73% in RA and from 33% to 47% in SpA. However, only 22% of patients were vaccinated annually over 5 years (22% RA, 22% SpA), while 19% never received this vaccine. Older age was associated with higher influenza vaccination uptake in both groups. In SpA, experiencing infections during follow-up was associated with higher influenza vaccination rates.

CONCLUSION

Pneumococcal vaccination coverage was high among patients monitored annually by a TPE nurse. Influenza vaccination coverage improved over time but remained insufficient, particularly among patients with SpA.