Pneumococcal and influenza vaccination coverage in patients with inflammatory rheumatic diseases receiving immunosuppressive therapy and annual nurse-led education

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2026
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Abstract
Abstract Objectives Vaccination rates among patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) remain suboptimal. This study examined the uptake of pneumococcal and influenza vaccines among patients undergoing immunosuppressive therapy and receiving annual nurse-led education. Methods Patients with RA or SpA who initiated their first biologic therapy between 2015 and 2017, and attended yearly visits with a rheumatologist and a therapeutic patient education (TPE) nurse over five years were included. Adherence to pneumococcal and influenza vaccine recommandations and factors associated with vaccine uptake were assessed. Results A total of 156 patients were analysed: 60 RA and 96 SpA. Overall, 81% (95% CI: 74–87) adhered to the five-year pneumococcal vaccination recommendations (82% in RA and 80% in SpA). Among patients with RA, a history of major adverse cardiac events or deep vein thrombosis/pulmonary embolism at baseline and the occurrence of myocardial infarction or stent placement during follow-up, were associated with non-adherence. Among patients with SpA, those who experienced infections during follow-up were more likely to adhere to the pneumococcal vaccination recommendations. Between 2015 and 2022, influenza vaccination rates increased from 63% to 73% in RA and from 33% to 47% in SpA. However, only 22% of patients were vaccinated annually over five years (22% RA, 22% SpA), while 19% never received this vaccine. Older age was associated with higher influenza vaccination uptake in both groups. In SpA, experiencing infections during follow-up was associated with higher influenza vaccination rates. Conclusion Pneumococcal vaccination coverage was high among patients monitored annually by a TPE nurse. Influenza vaccination coverage improved over time but remained insufficient, particularly among patients with SpA.
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Authors Françoise Fayet, Céline Lambert, A. Fan, M.H. Salembien, Coralie Yvars, Malory Rodère, Carine Savel, Elodie Vandemeulebroucke, Marion Guittard, Natacha Mrozek, Anne Tournadre, M Soubrier
Journal Rheumatology Advances in Practice
Year 2026
DOI
10.1093/rap/rkag075
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