Infectious Disease

Influenza vaccine uptake ‘suboptimal’ in adults with early rheumatoid arthritis

April 28, 2022

2 min read

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The authors report no relevant financial disclosures.

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Influenza vaccination coverage in adults with early rheumatoid arthritis in Canada remains “suboptimal,” according to data published in ACR Open Rheumatology.

“Despite the accessibility and affordability of effective vaccines, influenza significantly contributes to the mortality rate and health care burden in Canada, with yearly estimates of 12,000 hospitalizations and 3,500 deaths,” Viviane Ta, MSc, of McGill University, in Montreal, and colleagues wrote . “The incidence of influenza is higher in adults with rheumatoid arthritis (RA) than in the general population.”

Graphic showing influenza vaccine uptake.

Influenza vaccination coverage in adults with early RA in Canada remains “suboptimal,” according to data derived from Ta V, et al. ACR Open Rheumatol. 2022;doi:10.1002/acr2.11427.

To investigate influenza vaccine uptake and sociodemographic characteristics among adults who were recently diagnosed with RA, Ta and colleagues analyzed data from the Canadian Early Arthritis Cohort (CATCH) study. The study ran from September 2017 through February 2021. Researchers included data from baseline and 1-year follow ups. Patients diagnosed by a study physician were eligible to enroll.

The researchers analyzed sociodemographic variables, clinical status, medication use and influenza vaccination status in the 12 months prior to enrollment. Additionally, patients completed the Beliefs About Medicine questionnaire at baseline and 1 year. Researchers calculated a Necessity-Concerns differential (NCD) as the difference between necessity and concern subscale scores. Higher NCD stores indicated stronger beliefs about benefits compared with risks of RA medications.

The final cohort included 431 patients who completed the baseline questionnaire and had influenza vaccine data from the previous year available.

In all, 229 patients had influenza vaccination data and questionnaire scores available at 1 year of follow up. Among these patients, 105 — or 46% — reported receiving an influenza vaccine, according to the researchers. Among the vaccinated, 66% received the shot prior their RA diagnosis. Of the 124 patients who were not vaccinated for influenza at 12 months, 16% reported vaccine coverage prior to being diagnosed with RA, the researchers wrote.

Patients with previous influenza vaccinations (OR = 15.33; 95% CI, 6.37-36.9), current biologics or Janus kinase inhibitor use (OR = 5.42; 95% CI, 1.72-17.03) and a higher change in NCD scores (OR = 1.08; 95% CI, 1.02-1.15) demonstrated a higher likelihood of being vaccinated. Meanwhile, women (OR = 0.32; 95% CI, 0.14-0.71), patients with “non-white racial background” (OR = 0.13; 95% CI 0.04-0.51) and current smokers (OR = 0.09; 95% CI, 0.02-0.37) had a lower likelihood of vaccine coverage, the researchers wrote.

“Similar to patients with established RA, our results indicate that influenza vaccination coverage in patients with early RA remains suboptimal,” Ta and colleagues wrote. “Previous vaccination, selected RA treatments (being on advanced therapeutics), sociodemographic characteristics (white, male), lifestyle (not smoking), and a stronger belief in the necessity of medications to control RA relative to medication concerns are markers of individuals more likely to be vaccinated.”

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