Vaccinations and RA patients on immunosuppressive therapy
What is already known?
People with rheumatoid arthritis are at a greater risk of infections than the general population. It is recommended that people with rheumatoid arthritis who are prescribed immunosuppressive medication have yearly influenza and a pneumonia vaccination to reduce the chances of these infections. There have been studies In the UK, that have described how many people with rheumatoid arthritis have received influenza and pneumonia vaccinations, however these have been small, often describing patients attending a single hospital. The aims of this study were: (1) To describe how many people in the UK with rheumatoid arthritis who are prescribed immunosuppressive medication received influenza and pneumonia vaccinations and (2) To see how those who are vaccinated differed from those not vaccinated and (3) To compare vaccination rates across regions of the UK.
What was discovered?
There were 15,724 people with rheumatoid arthritis who were prescribed immunosuppressive medication identified from the Clinical Practice Research Datalink (CPRD), a general practice research database. Over, on average, a 5 year period, 80% received at least one influenza vaccination, and 50% received a pneumonia vaccination. Fewer patients who were aged less than 65 years at the time of diagnosis of their rheumatoid arthritis were vaccinated compared to those aged over 65 years at the time of diagnosis. Of those who were expected to have up to 5 influenza vaccinations, between 35% and 49% received all expected vaccinations. Those who were vaccinated were in older age groups, had other diseases where vaccination is recommended and visited their GP more often. When regions were compared Northern Ireland had the highest rates of vaccination, and with London had the lowest rates of vaccination.
Why is this important? What is the benefit to patients?
Vaccinations are an important way to prevent infections. This study highlights that many people with rheumatoid arthritis who are prescribed immunosuppressive medication are not receiving regular influenza vaccinations and are often not vaccinated against pneumonia. People who are below 65 years of age at the time of diagnosis and have no other illnesses where vaccination is recommended, are most often missed.