AB1248 Vaccination rate in patients with rheumatic diseases: a cross-sectional study in mexican patients

Abstract

BackgroundPatients with rheumatic diseases have an increased risk of infections, which can be prevented with vaccination schemes. The vaccination rate in rheumatic patients is low in Mexico (17%–25%), mainly because of the lack of physician recommendation. Vaccination strategies have been shown to improve adherence to the application.ObjectivesThe objectives of the study was to determine the vaccination rate in patients with rheumatic diseases and the main reasons of failed vaccination.MethodsWe questioned 84 patients from the rheumatology clinic of the Univesitary Hospital “José E. González”, Mexico, from June to July 2017. The vaccination status and the reasons for failed vaccination were recorded.ResultsThe majority of patients were women (89.3%), average age 50 years (17–81 years). Most of the patients had rheumatoid arthritis (45.3%), followed by other autoimmune diseases (27.4%) and non-autoimmune diseases (27.4%). The highest rates of vaccination were for tetanus-diphtheria (44%), influenza (39.3%) and pneumococcus (31%). They were lower for hepatitis B virus (9.8%), human papilloma virus (4.8%), hepatitis A virus (2.4%) and herpes zoster virus (0%). The main reason for failed vaccination was the lack of indication from the physician (34.5%). If indicated, 89.3% of the patients would accept to be vaccinated.Abstract AB1248 – Table 1Vaccination rateInfluenzaPneumococcusHepatitis BHuman PapillomavirusHerpesZoster Rheumatoid Arthritis15 (39%)16 (42%)3 (7.9%)1 (2.6%)0 (0%) Systemic Lupus Erythematosus2 (25%)1 (12.5%)1 (12.5%)1 (12.5%)0 (0%)Spondyloarthritis1 (33%)1 (33.3%)0 (0%)0 (0%)0 (0%)Systemic sclerosis2 (25%)2 (25%)0 (0%)0 (0%)0 (0%)Other autoimmune diseases0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)Reason of failed vaccinationN%Lack of medical recommendation29 (34%)Fear of vaccine side effects8 (9.5%)Previous vaccine side effects2 (2.4%)Disbelief in vaccination7 (8.3%)Other reasons35 (41%)ConclusionsWe found a low vaccination rate in the rheumatology clinic. We found an insufficient promotion and indication of vaccination by the rheumatology staff. Constant fomentation and updated knowledge about vaccination recommendations in autoinmune diseases is necessary for the prevention of infections and to improve the comprehensive care of patients with rheumatic diseases.References[1] Garg S. ACR Abstracts. 2016.[2] Kostantinos T & Vassilopoulus D. Best Practice & Research Clinical Rheumatology xxx (2016) 1e18.[3] Black S, et al. ACR Abstracts. 2011.[4] Bühler S, et al. Swiss Med Wkly. 2015;145: w14159Disclosure of InterestNone declared

Knowledge and attitudes about influenza vaccination in rheumatic diseases patients

“…[12][13][14][15][23][24][25][26][27][28][29][30] In our study, 79.8% of patients with RD (including AID and other non-AID) were vaccinated for influenza at least once, this is above other studies who had evaluated influenza vaccine uptake at any time in unselected RD population, who reported as low as 0.4% in China, 30 28% in France, 24 34% in Ireland during the previous 12 months, 13 38% among autoimmune inflammatory joint disease patients under biologic therapy also in France, 31 and 39.3% in a previous pilot study in our center. 28 Taking account only the RA patients, the vaccine uptake persists high in 80.3% compared with other RA populations, who had reported an influenza vaccine uptake in the United Kingdom of 46% of patients with <65 years and 81% of patients with >65 years by Fahy et al 23 57% in the previous 12 months also in the United Kingdom by Bridges et al 12 59.7% in France by Hua et al 14 60.1% in the international COMORA cohort being the lowest in Egypt with 28.7% and the highest in the United States with 89.2% reported by Hmamouchi et al 26 and 65.3% in Germany by Feuchtenberger et al 25 Most of the patients knew that influenza vaccine is freely provided (in Mexico), but among those who had never been vaccinated the proportion of patients who did not know it was higher, to our knowledge only the study by Jiang et al explore the cost as a factor in RD patients, they report 3% of patients who had never been vaccinated because the vaccine was too expensive. 30 We also found in the group of patients who had never been vaccinated for influenza more concerns about its efficacy being part of the factors that affect vaccine hesitancy; 26.7% of patients in this group did not consider influenza vaccine safe and effective, 24.4% of patients of this same group did not consider the vaccine as the best way to avoid complications, it is a high proportion compared to other reports ranging from 5% to 27%.…”