Low vaccination rates among patients with rheumatoid arthritis in a German outpatient clinic

Abstract

Patients with rheumatoid arthritis (RA) are at an increased risk of acquiring infections due to two reasons: the disease itself and the immunosuppressive therapy. Vaccinations against preventable diseases are therefore of utmost importance for these group of patients. To estimate vaccination frequencies among patients with rheumatoid arthritis, we studied patients in a survey and calculated vaccination rates based on their vaccination documents. Patients have been recruited from our outpatient clinic during one of their routine visits. For the statistical analysis, they have been divided by age (≥60 vs <60 years) and medication (DMARD, Biologics, TNF inhibitors) for further subgroup analysis. Among the studied patients (n = 331), we found rather low vaccination rates, in particular for the strongly recommended vaccines against Pneumococcus and Influenza (33 and 53%, respectively). Furthermore, protection rates for important basic vaccinations, e.g. against Pertussis, were found to be very low with 12% only. Beside these findings, we saw age-dependent differences for a variety of vaccines: while Pneumococcus and Influenza vaccines were more often given to patients ≥60 years, MMR, Pertussis, Diphtheria and Hepatitis were significantly more often applied to younger patients. Vaccination rates have to be improved among RA patients, in particular for vaccines protecting from respiratory tract infections such as Pneumococcus.

Low Influenza, Pneumococcal and Diphtheria–Tetanus–Poliomyelitis Vaccine Coverage in Patients with Primary Sjögren’s Syndrome: A Cross-Sectional Study

“…This lower use of bDMARDs compared to other studies conducted on RA and SpA may explain the lower vaccination coverage for influenza and pneumococcus but does not explain the low immunization coverage for DTP. This rate was similar to that reported in a recent study in Germany of 331 patients with RA, where 43% of patients received an anti-tetanus booster in the previous 10 years, and 26% and 16.9% were up-to-date for their diphtheria and polio vaccines, respectively [21]. In this study, the rate of vaccine coverage was significantly better for older than younger patients.…”

Interventions to improve vaccine acceptance among rheumatoid arthritis patients: a systematic review

“…Despite current recommendations that identify RA patients as a high-priority group for vaccination [ 9 ], vaccination coverage among RA patients is suboptimal [ 10 ]. Reported immunization rates range between 25–90% for influenza and 17–62% for pneumococcus [ 10 – 15 ]. This is often below the target proposed by the World Health Assembly for seasonal flu vaccination coverage in at-risk populations which is 75% [ 16 ].…”

Versorgungssituation der rheumatoiden Arthritis in Deutschland

“…Die Impfraten bei Personen mit RA sind in PROCLAIR und in der Kerndokumentation besser als in der Allgemeinbevölkerung, aber insgesamt liegen sie auf einem niedrigen Niveau [6]. Dies bestätigen Ergebnisse einer monozentrischen Studie aus Leipzig, die vergleichbar niedrige Impfraten unter ihren Patienten erhoben hat [12]. Die Diskussion, wer die Versorgung der Impfungen übernimmt und ob die Rheumatologen die Indikation dazu stellen sollten, bleibt also fortzuführen.…”