AB0549 Outcomes of Vaccination Among Filipino Lupus Patients Seen at the Philippine General Hospital: A One- Year Follow- Up Study
Authors: A.T.S. Hernandez, M.L. Tee, A.D. Corpuz, J.L. Hipe, K.D. Tee
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Vaccination of lupus patients has been widely advocated. However, certain factors contribute to a patient9s response to the vaccine. Studies have documented that certain medications including the dose, and the patient9s disease activity in particular, are factors that affect the response. Although certain reports have studied this occurrence, this has not been particularly addressed in our population, thus our objective of describing the outcomes of influenza and/ or pneumococcal vaccination among Filipino SLE patients seen at the Philippine General Hospital. <h3>Objectives</h3> To describe the outcomes of influenza and/ or pneumococcal vaccination among Filipino SLE patients seen at the Philippine General Hospital <h3>Methods</h3> We interviewed patients at baseline (two weeks prior to vaccination) to determine the medications they took and their disease activity prior to vaccination. One year after, these patients were followed- up and were asked regarding vaccine- related outcomes such as development of flu, flu- like symptoms, or pneumonia during the interim. All patients consented for this interview. <h3>Results</h3> Thirty- one lupus patients were included in the study. Of the 31 patients, 24 received influenza vaccine, 3 received pneumococcal vaccine, and 4 received both. In the influenza group, 5 developed flu or flu- like illnesses and 2 developed pneumonia. Of these two patients, one was managed as an out- patient, while the other was admitted. In the pneumococcal group, none developed pneumonia but 1 suffered from flu. In the group that received both, one developed flu and one expired due to severe sepsis from pneumonia. When these patients with adverse outcomes (n=10) were pooled and were compared with the group who did not suffer any unwanted events (n=21), it was noted that the patients who suffered from adverse outcomes had a longer- standing disease, had higher steroid doses, with a higher baseline disease activity. <h3>Conclusions</h3> While various guidelines recommend vaccination among patients with systemic lupus, we have observed that better outcome is seen among patients with low disease activity and those with little or no intake of immunosuppressive agents. These factors should be well- accounted for to ensure the best vaccination outcomes among lupus patients. <h3>References</h3> Campos LM, Silva CA, Aikawa NE, Jesus AA, Moraes JC, Miraglia J, Ishida MA, Bueno C, Pereira RM, Bonfa E. High disease activity: an independent factor for reduced immunogenicity of the pandemic influenza a vaccine in patients with juvenile systemic lupus erythematosus. Arthritis Care Res. 2013 Jul 65 (7): 112-7. Crowe SR, Merrill JT, Vista ES, Dedeke AB, Thompson DM, Stewart SM, Guthridge JM, Niewold TB, Franek BS, Air GM, Thompson LF, James JA. Influenza vaccination responses in human systemic lupuserythematosus: impact of clinical and demographic features. Arthritis Rheum. 2011 August; 63(8): 2396–2406. Del Porto F, Lagana B, Biselli R, Donatelli I, Campitelli L, Nisini R, Cadelli P, Rossi F, De9 Amelio R. Influenza vaccine administration in patients with systemic lupus erythematosus and rheumatoid arthritis: Safety and immunogenicity. Holvast A, Huckriede A, Wilschut J, Horst G, De Vries JJ, Benne CA, Kallenberg CG, Bijl M. Safety and efficacy of influenza vaccination in systemic lupus erythematosus patients with quiescent disease. Ann Rheum Dis 2006; (65): 913- 918. <h3>Disclosure of Interest</h3> None declared