Abstract
BackgroundPatients receiving biological therapy for auto-immune diseases are considered immunodepressed and multiple recent recommendations highlight the need for vaccination against influenza and pneumococcal infections.ObjectivesTo evaluate influenza and pneumococcal vaccine coverage in patients receiving biological therapy for spondyloarthritis (SpA), and to identify factors associated with vaccination completion in this population.MethodsWe conducted a prospective cross-sectional study of a cohort of 500 patients taking biological therapy for axial spondyloarthritis between june 2021 and june 2022 in five teaching hospitals in France (university hospital centers Bordeaux, Clermont-Ferrand, Limoges, Montpellier-Nimes and Toulouse). Influenza and pneumococcal vaccine coverage rates were collected using a self-administrated questionnaire. Patients were queried about knowledge and opinions about these vaccines. We also investigated the respective role of physicians and rheumatologists in the care and reasons for not proposing the vaccines. SARS- COV 2 impact and vaccine rates were also assessed. To identify factors associated with influenza vaccination and with pneumococcal vaccination, we performed a univariate and multivariate analysis.ResultsInfluenza vaccination was received by 46.8 % (n = 234) of patients. Pneumococcal vaccine had been previously administered to 61.7% (n = 307) of patients. Vaccination coverage against SARS-CoV-2 was high with 91.8% of vaccinated patients. Overall vaccine coverage rates were 34.6% for patients who received both influenza and pneumococcus vaccines and were 33% for those who received influenza, pneumococcus and Sars-COV2 vaccines. Factors associated with vaccinated status were a higher level of education (OR =1.66 (1.03-2.68), p=0.038) and taking part in educational therapy session (OR = 1.85 (1.12-3.06), p= 0.016) for pneumococcus, affiliation to a patients’ association (OR=4.10 (1.10-15.2), p=0.035) and intravenous administration of bDMARD (OR = 3.12 (1.76-5.54), p=0,0001) for influenza. Patients reported that they did not seek vaccination (influenza, pneumococcus or both) because (1) they did not receive appropriate information on vaccination and (2) fear possible side effects.ConclusionThis study showed insufficient vaccine coverage rates in a population at high risk because of exposure to biological therapy. Reasons for not being vaccinated included fear of adverse effects and lack of information and recommendations. Patient information by healthcare professionals about influenza and pneumococcal vaccination has a major impact and physicians should inform patients about vaccination as often as possible.REFERENCES: NIL.Graph 1.Comparison between vaccine coverage groupsTable 1.Reasons for non-vaccinationReasons for non-vaccination (%)InfluenzaPneumococcusBoth vaccineLack of proposal40%33%23%Fear side effect17%16%9%Advise against the vaccine by medicine2%2%8%Useless5%6%3%Non indication2%3%1%Forget or lack of time9%7%5%AcknowledgementsThe logistics of the investigators’ meetings were financially supported by Roche Chugai, we thank’s a lot. Roche Chugai had no role in the design, conduction, analysis, or interpretation of the study.Disclosure of InterestsAMORY Charlotte: None declared, Thomas Barnetche Paid instructor for: Biogen, Claire Rempenault: None declared, DESPRES Jerome: None declared, Jessika BERNARD: None declared, Maxime Vandersmissen: None declared, Justine LANDRIN: None declared, Adeline Ruyssen-Witrand Speakers bureau: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Fresenius-Kabi, Galapagos, Janssen, Lilly, MSD, Mylan, Nordic-Pharma, Novartis, Pfizer, Roche Chugai, Sanofi, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Mylan, Novartis, Pfizer Inc, Sanofi Genzyme, Grant/research support from: AbbVie, Amgen, Mylan, Pfizer Inc, Pascale Vergne-Salle Speakers bureau: Abbvie, Fresenius, Grünenthal, Janssen, Pfizer, Roche Chugai, Sanofi, Novartis, Mylan, UCB, Lilly, Consultant of: anssen, Abbvie, UCB, Cécile Gaujoux-Viala Speakers bureau: bbVie, Amgen, BMS, Boehringer Ingelheim, Celgene, Gilead, Janssen, Lilly, Medac, MSD, Mylan, Nordic Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi et UCB, Consultant of: bbVie, Amgen, BMS, Boehringer Ingelheim, Celgene, Gilead, Janssen, Lilly, Medac, MSD, Mylan, Nordic Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi et UCB, Jacques Morel Speakers bureau: Abbvie, Amgen, Biogen, BMS, Fresenius Kabi, Galapagos, Lilly, Médac, Novartis, Pfizer, Sandoz, Sanofi, Consultant of: Abbvie, BMS, Boerhinger Ingelheim, Galapagos, GSK, Lilly, Novartis, Sanofi, Anne Tournadre Speakers bureau: Abbvie, Fresenius, Janssen, MSD, Pfizer, Roche Chugai, Sanofi, Paid instructor for: Fresenius, Consultant of: Abbvie, Fresenius, Lilly, Novartis, Sanofi, Grant/research support from: Fresenius, Novartis, Pfizer, UCB, Cédric Lukas Speakers bureau: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Consultant of: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Grant/research support from: Pfizer, Novartis and Roche-Chugai,
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