Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Influenza infection poses significant risk to pregnant women, therefore it is recommended that all pregnant women be vaccinated. However, it is unknown whether the protective effect of influenza vaccine is the same for pregnant women with rheumatoid arthritis (RA) as it is for pregnant women without autoimmune disease.
Methods:
Data were obtained from an ongoing prospective cohort study of pregnancy outcome among women in the U.S. and Canada. We included women enrolled between 2009 and 2012 who either had a current diagnosis of RA or were healthy women without autoimmune disease. All women had completed multiple standard maternal telephone interviews during pregnancy that contained structured questions on the receipt of influenza vaccination and the occurrence of a diagnosis of influenza-like illness (ILI) during pregnancy. Using time varying vaccine exposure during pregnancy, and adjusting for the timing of the flu season during pregnancy, we estimated the hazard ratio (HR) and its 95% confidence interval (CI) for ILI in a Cox regression model comparing women who reported receipt of an influenza vaccine some time in pregnancy to women without vaccine during pregnancy. We addressed the potential differential effect of influenza vaccination on risk of ILI by testing an interaction term in the model (influenza vaccination by RA status). For those women who were vaccinated, only ILI reported subsequent to vaccination was included as an event.
Results:
There were 1,233 subjects available for analysis: 825 women received influenza vaccine during pregnancy and 408 women did not receive vaccine; 245 women had RA and 988 women were without autoimmune disease. Among RA subjects, 144 (58.8%) were vaccinated and among subjects without autoimmune disease, 681 (68.9%) were vaccinated. Nine (3.7%) of the women with RA and 55 (5.6%) of the women without autoimmune disease reported a diagnosis of ILI at some time in pregnancy. Six (4.2%) vaccinated RA women and 28 (4.1%) vaccinated women without autoimmune disease reported ILI at some time in pregnancy. The adjusted HR for ILI in women vaccinated vs. women not vaccinated was 1.19 with 95% CI of 0.64, 2.24. The interaction term for vaccine exposure and autoimmune disease was not statistically significant (p = 0.16).
Conclusion:
We found no evidence of a difference in the incidence of ILI after vaccination is pregnant women with RA compared to women without autoimmune disease.
Disclosure:
Y. Luo,
None;
D. L. Johnson,
Abbott Laboratories,
2,
Amgen,
2,
UCB,
2,
Roche Genentech,
2,
Sanofi-Aventis Pharmaceutical,
2,
Bristol-Myers Squibb,
2,
Sandoz,
2,
Teva Pharmaceuticals,
2,
CSL,
2,
Apotex,
2,
Barr Laboratories, Inc.,
2,
Novartis Pharmaceutical Corporation,
2,
GSK,
2;
R. Xu,
Abbott Laboratories,
2,
Amgen,
2,
UCB,
2,
Roche Genentech,
2,
Sanofi-Aventis Pharmaceutical,
2,
Bristol-Myers Squibb,
2,
Sandoz,
2,
Teva Pharmaceuticals,
2,
Parr ,
2,
Apotex,
2,
Barr Laboratories, Inc.,
2,
Novartis Pharmaceutical Corporation,
2,
CSL,
2,
GSK,
2;
C. D. Chambers,
Abbott Laboratories,
2,
Amgen,
2,
UCB,
2,
Roche Genentech,
2,
Sanofi-Aventis Pharmaceutical,
2,
Bristol-Myers Squibb,
2,
Sandoz,
2,
Teva Pharmaceuticals,
2,
Parr ,
2,
Apotex,
2,
Barr Laboratories, Inc.,
2,
CSL,
2,
GSK,
2,
Novartis Pharmaceutical Corporation,
2.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-the-incidence-of-influenza-like-illness-in-pregnant-women-with-rheumatoid-arthritis-and-women-without-rheumatoid-arthritis-who-receive-an-influenza-vaccination/