Introduction: The objective of our study was to assess, in an at-risk population, perception and knowledge about influenza and pneumococcal vaccinations. Methods: An anonymous web-based survey was submitted to patients recruited in France, from both an Ipsos internal panel and AVNIR patient associations. The study was conducted between July and October 2020, in the context of the COVID-19 pandemic. Results: Overall, 2177 questionnaires from patients at risk of infection were analyzed. Almost all respondents (86%, 1869/2177) declared themselves to be favorable to vaccination. Nearly half of the patients (49%, 1069/2177) were aware of which vaccine was recommended for their specific situation. This percentage was significantly (p < 0.001) higher for members of a patient association and for people affected by multiple chronic conditions and varied according to the type of condition. Almost two-thirds of patients (1373/2177) declared having been vaccinated during the 2019/2020 influenza season, and 41% (894/2177) were certain about being up to date with the pneumococcal vaccination. The main barriers to vaccination for influenza are the fear of side effects, doubt regarding the efficacy of the vaccine and for pneumococcal vaccination, and the absence of suggestions by the healthcare professionals (HCPs), as 64% of respondents were not recommended to obtain pneumococcal vaccination. To improve vaccine coverage, information is of prime importance and GPs are recognized as the main HCP to inform about vaccination. Nearly two-thirds (62%, 1360/2177) of patients declared that the COVID-19 pandemic convinced them to have all the recommended vaccines. Conclusion: Our study highlighted the nonoptimal vaccine coverage in at-risk populations despite a highly positive perception of vaccines and confirmed that physicians are on the front lines to suggest and recommend these vaccinations, especially in the current pandemic context, which may be used to promote other vaccines.

Background Network PR-LR is designed to improve the management of patients with rheumatoid arthritis (RA) in the Languedoc Roussillon (France). It conducts training activities, information for patients and health professionals on rheumatoid arthritis. It now has 1,263 patients. There is an anonymized medical records and computerized for each patient which allows regular monitoring. Objectives Compare the consumption of medical procedures between patients in or those outside to the network system. Methods To study the data from RA patients, we asked to the regional health insurance company (RHIC) a list of patients with medical and economic information usable. We gave the health insurance list of patient care within the network. The RHIC has extracted about two years (June 2009-July 2011) a database containing anonymised patient outside the network PR-LR. Once we got the information from the RHIC, we analyzed several criteria: per diem reimbursement, visits to the doctor, number of visits to specialists, many acts of biology and radiology. Other criteria have not yet been exploited due to lack of data: type of treatment (use of corticosteroids, NSAIDs, DMARDs or biological agents), number of hospitalizations, surgical procedures. For comparison of common variables, we used a Chi2 test. Results Over the period studied, we obtained 5936 non-network patients versus 465 patients in the network and living in the Languedoc Roussillon. Non-network patients (N=5936) were a mean age of 61.86 years (SD 15.18), duration symptoms RA of 6 years (SD 3.8). There are 1631 men and 4305 women. The sex male/female ratio is 0.37. Patients Network (N=465) had a mean age of 62.49 years (SD 14.71), an unknown length of RA. There are 99 men and 306 women. The sex male/female ratio is 0.27. There is a significant difference between the 2 groups. In the Network patients group, we observed: less diem reimbursement: 13.55 (71.32) vs 22.71 (91.13) p=0.0088 Fewer visits to the doctor: 10.73 (10.81) vs 13.66 (11.36) p=0.00001 No difference in the number of specialist consultations: 7.34 (7.62) vs 7.52 (7.11) p=0.1761 No differences in the number of acts of biology but more likely because follow-up is better: 47.11 (41.16) vs 41.88 (37.06) p=0, 0532 Less X-ray procedures: 6.78 (6.97) vs 8.55 (8.35) p=0.00001 Less Radiographs of hands for better monitoring: 0.37 (0.78) vs 0.55 (1.09) p=0.0081. Warning of the date of the last ray is given to the physician No differences in the number of radiographs of the feet: 0.55 (1.04) vs 0.49 (0.99) p=0.1897 Conclusions This study has many limitations but shows for the first time a benefit of a network of care on the treatment of RA patients. Better monitoring through the computer interface allows us a better tight control of the patient and a profit on medical consumption shown by the decrease in visits to the doctor, acts of x-rays and the number of per diem reimbursement. Disclosure of Interest None Declared