Background: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) have a higher burden of infectious diseases compared to the general population. This could be explained by the disturbances in their immune system response, comorbidities and immunosuppressive treatment.Vaccination is the most effective measure to prevent infections.
Objectives: To describe a cohort of patients with AIIRD referred to the infectious disease´s unit according to the vaccination protocol.
Methods: Restrospective and descriptive study of a cohort of 286 patients with AIIRD who were evaluated in the rheumatology service of a tertiary hospital in Barcelona and referred to the infectious disease´s unit according to the vaccination protocol among 1 year,between January 1 rst December 31 st , 2019. The vaccination protocol included serologies of human immunodeficiency virus,hepatitis A,B and C, varicella zoster,tuberculosis,measles,mumps and rubella virus.The recommended vaccines were H.influenzae b,S.pneumonia, influenza,hepatitis A and B(immunity absence), meningococcus c ,tetanus – diphtheria (low antigenic load),poliomyelitis and human papillomavirus (not vaccinated).The patients included were diagnosed with a rheumatologic condition under immunosuppressive therapy. Demographic variables,diagnosis,treatment,vaccines administered,infections and adverse effects were collected.
Results: Of 286 patients reviewed the mean age was 61, 4 (±14.4) years. The characteristics of the cohort are shown in
CHARACTERISTICS OF COHORT OF PATIENTS
Sex n % (women/men) | 193/93 (67,5/32,5) |
Age, years ± DE | 61.4 ± 14.4 |
Diagnoses AIIRD, n (% ) | |
Rheumatoid arthritis n (%) | 164 (57.3) |
Systemic lupus erythematosus n (%) | 6 (2.1) |
Sjögren´s syndrome n (%) | 9 (3.1) |
Systemic sclerosis n (%) | 1 (0.35) |
Inflammatory myopathie n (%) | 5 (1.7) |
Vasculitis n (%) | 36 (12.6) |
Polymyalgia rheumatica n (%) | 4 (1.4) |
Spondyloarthropathy n (%) | 46 (16.1) |
Others n (%) | 15 (5.2) |
Treatment AIIRD | |
GCs n (%) | 116 (40.7) |
csDMARDs n (%) | 149 (52.1) |
bDMARDs n (%) | 80 (27.8) |
tsDMARDs n (%) | 7 (2.4) |
Others 1 n (%) | 12 (4.2) |
GCs + csDMARDs n (%) | 59 (21) |
GCs + bDMARDs n (%) | 14 (4.9) |
GCs + csDMARDs + bDMARDs n (%) | 4 (1.4) |
Vaccines | |
PCV 13 n (%) | 283 (99) |
PPSV23 n (%) | 265 (93) |
HiB n (%) | 265 (93) |
NM n (%) | 247 (86.7) |
Influenza n (%) | 128 (44.9) |
HBV n (%) | 121 (42.3) |
Vaccination before IS n (%) | 41 (14.3) |
Vaccination with IS n (%) | 244 (85.3) |
Other: Behcet,Adult Stills,Relapsing polychondritis,IGg4 related disease,Sarcoidosis
Others 1 : Mycophenolic acid,cyclosporine and tacrolimus
Conclusion: In our cohort, the vaccination protocol proved to be a good tool to improve the vaccination rate of rheumatological patients, despite this, the vaccination of Hepatitis B and specially of influenza, continues to have a lower prevalence to general population.The vaccines were effective since none of the preventable infections occurred during follow up, despite the use of an immunosuppressant. Vaccination showed a good safety profile, without reported serious adverse effects or worsening of the underlying disease.
Disclosure of Interests: None declared