UPTAKE OF PNEUMOCOCCAL AND INFLUENZA VACCINATION IN PATIENTS RECEIVING BIOLOGICAL DMARDS IN IRELAND
W. L. Ng1, 2, A. Anjum1, 2, A. Sebastian1, 2, E. Fitzgerald1, 2, M. Brady1, 2, B. McCarthy2, M. Gillespie1, J. Devlin1, 2, A. Fraser1, 2
1Rheumatology, University Hospital Limerick, 2Rheumatology, Croom Orthopaedic Hospital, Limerick, Ireland
Biological disease-modifying antirheumatic drugs (bDMARDs) have made significant positive outcomes in the lives of patients with rheumatic disease. Studies have shown that pneumococcal vaccination is cost effective while influenza vaccination significantly prevents morbidity and mortality in the elderly and in patients with chronic disease.
To evaluate the pneumococcal and influenza vaccination status in patients receiving bDMARDs.
Patients on bDMARDs attending the rheumatology infusion unit were asked about their vaccination status on pneumococcal and influenza. The patients’ current bDMARD and reasons for not having vaccination were recorded.
Mean age of 92 patients were 53.2years. 30(32.6%) patients received both vaccines, and 39(42.4%) had neither. Of the 18(19.6%) patients age >65 years, 5(27.8%) received influenza vaccination alone and 8(44.4%) received both. Patients who did not receive vaccinations were given an educational booklet. 48(52.2%)on rituximab, 37(40.2%) on infliximab, 6(6.5%) on tocilizumab and 1(1.1%) was on abatacept. Of the 61(66.3%) patients who did not receive the pneumococcal vaccine, 44(72.1%) were unaware of its availability, 6(9.8%) were not interested, 4(6.6%) were afraid of the side effects, 4(6.6%) declined vaccination and 3(4.9%) were unaware it was recommended. 40(43.5%) who did not receive the influenza vaccine stated that they were either unaware(45%), not interested(25%), declined vaccination(10%), forgotten(5%), unaware it was recommended(5%) and afraid of the side effects(2.5%). 3(7.5%) had previous bad experiences from influenza vaccination.
This is the first study in Ireland on vaccination uptake in patients on bDMARDS. Patients on immunosuppressants are recommended to have these vaccinations, preferably before commencing on immunosuppressants. The vaccination rate in our cohort was less than satisfactory. Hence, primary care physicians and the rheumatology team should take active roles in increasing awareness amongst patients on pneumococcal and influenza vaccination.