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Vaccination against influenza and pneumococcal infections in patients with autoimmune disorders under biological therapy: Coverage and attitudes in patients and physicians.
Eur J Intern Med. 2019 Nov; 69:25-31.EJ

Abstract

BACKGROUND

Patients under biological therapy for auto-immune disease are considered immunosuppressed and several recent recommendations highlight the need for vaccination against influenza and pneumococcal infections. The aims of this study were to evaluate influenza and pneumococcal vaccine coverage among patients receiving biological therapy and identify factors associated with vaccine uptake within this population.

METHODS

A retrospective cross-sectional study was performed in adult patients attending hospitals for an auto-immune/inflammatory disease and treated with biological therapy. Vaccine uptake was evidenced from patient's medical records or from their pharmacist's records. Questionnaires about attitudes and knowledge regarding vaccinations were administered to patients and their physicians. Multivariable logistic regression was used to determine factors significantly associated with influenza and pneumococcal vaccine receipt.

RESULTS

A total of 208 patients were included: 52% female and mean age 50.6 (± 14.7) years. Among them 173 completed the questionnaire while 72 physicians replied. Underlying inflammatory diseases were rheumatisms (46%), bowel diseases (31%) and skin diseases (23%). Vaccine uptake was 28% for influenza, 48% for pneumococcus and 22% received both vaccines. Main factors associated to positive uptake were receiving a prescription from a physician, as well as having a good knowledge of vaccines. Factors limiting vaccination were a negative attitude toward vaccines in general, and belonging to the group of inflammatory bowel diseases.

CONCLUSIONS

Vaccine coverage for influenza and pneumococcal infections are low in the patients under biologics for auto-immune/inflammatory disease. Health policies should reinforce information and promotion of these vaccines among these patients but also the prescribers.

Authors+Show Affiliations

Internal Medicine and Dermatology Unit, Reunion University Hospital, Saint Denis, Reunion Island, France. Electronic address: hajer.eleuchi@gmail.com.Statistics and methodological Unit, INSERM CIC 1410, Reunion University Hospital, Saint Denis, Reunion Island, France. Electronic address: emmanuel.chirpaz@chu-reunion.fr.Internal Medicine Unit, Reunion University Hospital, Saint Pierre, Reunion Island, France. Electronic address: aurelie.foucher@chu-reunion.fr.Internal Medicine and Dermatology Unit, Gabriel Martin Hospital, Saint Paul, Reunion Island, France. Electronic address: sultanbichat.n@ch-gmartin.fr.Internal Medicine Unit, GHER Hospital, Saint Benoit, Reunion Island, France. Electronic address: a.randrianjohany@gher.fr.Internal Medicine Unit, Reunion University Hospital, Saint Pierre, Reunion Island, France. Electronic address: patrice.poubeau@chu-reunion.fr.Rheumatology Unit, Reunion University Hospital, Saint Denis, Reunion Island, France.Internal Medicine and Dermatology Unit, Gabriel Martin Hospital, Saint Paul, Reunion Island, France. Electronic address: roussin.c@ch-gmartin.fr.Internal Medicine and Dermatology Unit, Reunion University Hospital, Saint Denis, Reunion Island, France. Electronic address: sophie.osdoit@chu-reunion.fr.Internal Medicine and Dermatology Unit, Reunion University Hospital, Saint Denis, Reunion Island, France. Electronic address: loic.raffray@chu-reunion.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31445784

Citation

Lejri-El Euchi, Hajer, et al. "Vaccination Against Influenza and Pneumococcal Infections in Patients With Autoimmune Disorders Under Biological Therapy: Coverage and Attitudes in Patients and Physicians." European Journal of Internal Medicine, vol. 69, 2019, pp. 25-31.
Lejri-El Euchi H, Chirpaz E, Foucher A, et al. Vaccination against influenza and pneumococcal infections in patients with autoimmune disorders under biological therapy: Coverage and attitudes in patients and physicians. Eur J Intern Med. 2019;69:25-31.
Lejri-El Euchi, H., Chirpaz, E., Foucher, A., Sultan-Bichat, N., Randrianjohany, A., Poubeau, P., Gamon, E., Roussin, C., Osdoit, S., & Raffray, L. (2019). Vaccination against influenza and pneumococcal infections in patients with autoimmune disorders under biological therapy: Coverage and attitudes in patients and physicians. European Journal of Internal Medicine, 69, 25-31. https://doi.org/10.1016/j.ejim.2019.08.010
Lejri-El Euchi H, et al. Vaccination Against Influenza and Pneumococcal Infections in Patients With Autoimmune Disorders Under Biological Therapy: Coverage and Attitudes in Patients and Physicians. Eur J Intern Med. 2019;69:25-31. PubMed PMID: 31445784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccination against influenza and pneumococcal infections in patients with autoimmune disorders under biological therapy: Coverage and attitudes in patients and physicians. AU - Lejri-El Euchi,Hajer, AU - Chirpaz,Emmanuel, AU - Foucher,Aurélie, AU - Sultan-Bichat,Nathalie, AU - Randrianjohany,Andry, AU - Poubeau,Patrice, AU - Gamon,Etienne, AU - Roussin,Céline, AU - Osdoit,Sophie, AU - Raffray,Loïc, Y1 - 2019/08/21/ PY - 2019/02/26/received PY - 2019/05/21/revised PY - 2019/08/13/accepted PY - 2019/8/26/pubmed PY - 2020/7/31/medline PY - 2019/8/26/entrez KW - Biological therapy KW - Immunocompromised host KW - Influenza KW - Knowledge KW - Pneumococcal infections KW - Vaccination SP - 25 EP - 31 JF - European journal of internal medicine JO - Eur J Intern Med VL - 69 N2 - BACKGROUND: Patients under biological therapy for auto-immune disease are considered immunosuppressed and several recent recommendations highlight the need for vaccination against influenza and pneumococcal infections. The aims of this study were to evaluate influenza and pneumococcal vaccine coverage among patients receiving biological therapy and identify factors associated with vaccine uptake within this population. METHODS: A retrospective cross-sectional study was performed in adult patients attending hospitals for an auto-immune/inflammatory disease and treated with biological therapy. Vaccine uptake was evidenced from patient's medical records or from their pharmacist's records. Questionnaires about attitudes and knowledge regarding vaccinations were administered to patients and their physicians. Multivariable logistic regression was used to determine factors significantly associated with influenza and pneumococcal vaccine receipt. RESULTS: A total of 208 patients were included: 52% female and mean age 50.6 (± 14.7) years. Among them 173 completed the questionnaire while 72 physicians replied. Underlying inflammatory diseases were rheumatisms (46%), bowel diseases (31%) and skin diseases (23%). Vaccine uptake was 28% for influenza, 48% for pneumococcus and 22% received both vaccines. Main factors associated to positive uptake were receiving a prescription from a physician, as well as having a good knowledge of vaccines. Factors limiting vaccination were a negative attitude toward vaccines in general, and belonging to the group of inflammatory bowel diseases. CONCLUSIONS: Vaccine coverage for influenza and pneumococcal infections are low in the patients under biologics for auto-immune/inflammatory disease. Health policies should reinforce information and promotion of these vaccines among these patients but also the prescribers. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/31445784/Vaccination_against_influenza_and_pneumococcal_infections_in_patients_with_autoimmune_disorders_under_biological_therapy:_Coverage_and_attitudes_in_patients_and_physicians_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(19)30295-X DB - PRIME DP - Unbound Medicine ER -