Background/Purpose:

The infections complicating rheumatic diseases cause significant morbidity and mortality. Rheumatoid arthritis and psoriatic arthritis patients are at increased risk of infection due to their altered immune system superimposed over the immunosuppressive effects of the treatment. The Center for Disease Control and Prevention is recommending that any person with rheumatoid arthritis should receive annual influenza vaccination. Despite these endorsements, the uptake of influenza vaccination in rheumatoid arthritis patients is low, and the rates of influenza vaccinations for psoriatic arthritis are largely unknown. The overall objective of this study is to understand the vaccination rate in our cohort of rheumatoid arthritis and psoriatic arthritis, and compare it with the literature reported rates in these populations. We also aim to understand the barriers for non-vaccination in a small subset of patients.

Methods:

All the patients from the Rheumatology clinic with a clinical diagnosis of either psoriatic arthritis or rheumatoid arthritis were included in the analysis. The data was collected by retrospective chart review for the last 2 influenza season. Vaccination status was verified based on the electronic medical record documentation. We offered the questionnaire to 35 consecutive patients with rheumatoid arthritis and 17 with psoriatic arthritis whose record of vaccination is No. If the answer was No, the patients were subsequently asked about reasons for non-vaccination.

Results:

We identified 526 patients with a diagnosis of psoriatic arthritis. The average age was 55.7. The gender distribution was 49.4% male, 50.6% females. Out of the 526 psoriatic arthritis patients, only 52.7% of them were “ever” vaccinated. This includes any reported vaccination since 2001. However, only 28.9% were vaccinated in the last 2 flu seasons. The Rheumatology clinic follows a total of 1489 patients with a diagnosis of rheumatoid arthritis. This subset of patients was slightly older that the PsA cohort, mean age 62.5, with 54.9% being female. The “ever” vaccination rate in this cohort was 61.3%. The vaccination rate in the last 2 winter seasons was much lower, only 37.4%. We compared the vaccination rates in the clinic, with the literature-reported vaccination rates in rheumatoid arthritis population. There was no difference in the vaccination rates between the PsA and RA cohort, and also no statistical difference between the vaccination rates in the 2 cohorts, based on sex. Among individuals with RA who ever received vaccination for influenza, the proportion of individuals who received the vaccine in the last two years was smaller in those younger than 65 compared with those older than 65, 51.7% and 63.7%, respectively (p=0.0001). Among individuals with PsA who ever received vaccination for influenza, the proportion of individuals who received the vaccine in the last two years was much higher in those older than 65 compared with those younger than 65, 38.7% vs. 4.02%% respectively (p=0.0001).

Conclusion:

Our result indicate that the influenza vaccination rates in a cohort of PsA and RA patients are very low, less than half of them receiving the influenza vaccine.

« Back to ACR/ARHP Annual Meeting 2018

ACR Meeting Abstracts - https://acrabstracts.org/abstract/rates-of-influenza-vaccination-in-a-cohort-of-patients-with-rheumatoid-arthritis-and-psoriatic-arthritis/