Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus

Abstract

Objective-To better understand why immunosuppressed individuals with systemic lupus erythematosus (SLE) fail to receive influenza and pneumococcal vaccines.Methods-These cross-sectional data derive from the 2009 cycle of the Lupus Outcomes Study (LOS), an annual longitudinal telephone survey of individuals with confirmed SLE. Respondents were included in the analysis if they had taken immunosuppressive medications in the past year. We assessed any prior receipt of pneumococcal vaccine and receipt of influenza vaccine in the past year, then elicited reasons for not receiving vaccination. We used bivariate statistics and multivariate logistic regression to assess frequency and predictors of reported reasons for not obtaining influenza or pneumococcal vaccines.Results-Among 508 respondents who received immunosuppressants, 485 reported whether they had received vaccines. Among the 175 respondents who did not receive an influenza vaccine, the most common reason was lack of doctor recommendation (55%), followed by efficacy or safety concerns (21%), and lack of time (19%). Reasons for not receiving pneumococcal vaccine (N=159) were similar: lack of recommendation (87%), lack of time (7%), and efficacy or safety concerns (4%). Younger, less-educated, non-white patients with shorter disease duration, as well as those immunosuppressed with steroids alone, were at greatest risk for not receiving indicated vaccine recommendations.Conclusions-The most common reason why individuals with SLE did not receive pneumococcal and influenza vaccines was that physicians failed to recommend them. Data suggest that increasing vaccination rates in SLE will require improved process quality at the provider level, as well as addressing patient concerns and barriers. Keywords systemic lupus erythematosus; preventive care; vaccine; quality of care

Risk of Bacterial Infection in Acquired Complement Deficiencies

“…Pediatric SLE/CTD with a tendency to consume complement may benefit from hyperimmunization and rapid receipt of empiric antibiotics similar to primary complement deficient patients [11]. Thus far, physicians are failing to recommend vaccines for SLE patients [12].…”

Analysis of the Juvenile Idiopathic Arthritis Immunization Schedule

“…Однако, до сих пор отдельные врачи-клиницисты рассматривают аутоиммунные заболевания в качестве противопоказаний к вакцинации. Исследование, прове-денное во Франции и Великобритании, продемонстриро-вало относительно низкий уровень охвата вакцинацией против гриппа и пневмококковой инфекции пациентов с ревматоидными заболеваниями -28 и 37% соот-ветственно [22]. Согласно результатам международ-ного одномоментного исследования, посвященного коморбидным состояниям при ревматических болезнях COMORA, включившего более 4500 больных ЮИА, пока-затели привитости оказались еще ниже -25 и 17% соответственно [18].…”

Vaccination in Patients With Systemic Lupus Erythematosus: Results and Prospects

“…Так, по данным немецких авторов, среди больных СКВ вакцинацию против гриппа и пневмококковой инфекции получили 49 и 21% соответственно [8]. Основными причинами низкого охвата вакцинацией больных ревматологического профиля являются отсутствие рекомендаций со стороны лечащих врачей и обеспокоенность в связи с возможными неблагоприятными реакциями (НР) [9][10][11][12].…”