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

Rheumatol Int. 2017 Feb;37(2):229-237. doi: 10.1007/s00296-016-3608-y. Epub 2016 Nov 22.

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.

Keywords: Anti-TNF therapy; DMARDs; Immunosenescence; Pneumococcus; Rheumatoid arthritis; Vaccination rates; Vaccinations.

MeSH terms

  • Adult
  • Age Factors
  • Ambulatory Care Facilities
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Female
  • Germany
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Influenza Vaccines
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines
  • Vaccination / statistics & numerical data*

Substances

  • Antirheumatic Agents
  • Influenza Vaccines
  • Pneumococcal Vaccines