Research from The University of Manchester has found a shortfall in the uptake of influenza and pneumococcal vaccinations among those diagnosed with rheumatoid arthritis (RA), potentially increasing their infection risk.
The team from the Arthritis Research UK Centre for Epidemiology looked at data from over 15,000 patients diagnosed with the disease who were being treated with certain types of immunosuppressive drugs, and found that one in five patients received no influenza vaccinations and one in two patients received no pneumonia vaccine over a five year follow-up period.
Patients with rheumatoid arthritis have double the normal risk of infection, due to a range of factors, compared to the rest of the population. Guidelines recommend that vaccinations should be used to protect against certain infections, such as influenza and pneumonia.
Dr Will Dixon, who led the study, said: “There is no national data on vaccination uptake broken down in a way that allows us to pull out those with RA. Only one study in the US has looked at whether patients with rheumatic diseases are being vaccinated prior to starting immunosuppressive therapy.”
This large study used information from electronic patient records to assess the take-up of the two vaccines. It looked at 15,724 patients diagnosed with RA between 2000 and 2013.
The group found that those who were younger, who did not meet another clinical risk category, and who visited their GP less often were least likely to be vaccinated.
Dr Ben Brown, a GP who was also part of the study team, added: “Guidance on influenza and pneumococcal vaccination for RA patients is unclear, and payment to carry it out in primary care is variable.
“In future it may be beneficial for rheumatologists to provide GPs with specific advice about appropriate vaccination for individual patients, or to consider administering the vaccinations themselves in their own clinics – either way, both approaches should be adequately funded.”
Richard Francis, head of research liaison and evaluation at Arthritis Research UK, said: “Around 400,000 people in the UK live with the excruciating pain of rheumatoid arthritis. The impact of rheumatoid arthritis and the drugs used to treat the condition on the ability to fight infection is significant, and this study underscores the importance of vaccination in helping prevent the impact of influenza and other infections.”
Influenza and Pneumococcal Vaccination Uptake in Patients with Rheumatoid Arthritis Treated with Immunosuppressive Therapy in the UK: A Retrospective Cohort Study Using Data from the Clinical Practice Research Datalink. Ruth Costello,Kevin L. Winthrop,Stephen R. Pye,Benjamin Brown,William G. Dixon. PLoS One. DOI: 10.1371/journal.pone.0153848. Published online April 20, 2016.