Pneumococcal vaccine uptake in patients with inflammatory arthritis: a single centre cohort study

Abstract

Abstract Introduction Current guidelines recommend pneumococcal vaccination in individuals who are over the age of 65 or are immunosuppressed due to a disease or treatment. The objective of this study was to assess vaccine uptake rates in people with inflammatory arthritis for the pneumococcal, influenza and Covid-19 vaccines and factors determining uptake. Methods We conducted a retrospective single centre cohort study in the UK of individuals with rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis between October and December 2023. Data were collected for age, gender, co-morbidities, immunosuppressive therapies and dates of vaccines. Logistic regression was used to evaluate predictors of vaccine uptake, with adjustments for demographic and clinical factors. Results Nine hundred and six individuals were identified; 46% were receiving treatment with conventional synthetic DMARD (csDMARD), 26% were on biologic monotherapy, and 23% were on both biologic and csDMARDs. Three hundred and sixteen individuals (35%) received a pneumococcal vaccine, lower than uptake for influenza (63%) and Covid-19 (87%) vaccines. Predictors of pneumococcal vaccine uptake included age, with older patients more likely to be vaccinated (odds ratio [OR] for age ≥ 65 years: 1.67; 95% CI: 1.21, 2.29). Those on biologic therapy demonstrated higher likelihood of vaccination (OR for biologic therapy: 1.81; 95% CI: 1.33, 2.47). Additional Joint Committee on Vaccination and Immunisation Green Book indicators also positively influenced vaccine uptake (OR: 1.67; 95% CI: 1.19, 2.33). Conclusion Pneumococcal vaccine uptake in inflammatory rheumatic diseases is low, especially in younger patients and those not on biologic therapy. The study highlights the need for a focused approach, distinct from strategies for other vaccines, to address this public health challenge.