THU0627 VACCINATIONS IN PATIENTS WITH AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASES: STILL ROOM FOR IMPROVEMENT
Authors: Delphine Bertrand, Sofie Coenen, Sofia Pazmino, Veerle Stouten, Diederik De Cock, Kristien Van der Elst, Rene Westhovens, Marc Ferrante, Patrick Verschueren
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Patients with autoimmune inflammatory rheumatic diseases (AIIRD) have an increased risk for acquiring infections. Vaccines were developed to diminish the prevalence of vaccine-preventable infections. The EULAR recommendations for vaccination in adult patients with AIIRD emphasise the importance of assessing the vaccination status of patients with AIIRD. <h3>Objectives</h3> To determine the vaccination status of patients with AIIRD, the reason for non-vaccination and the proportion of patients that are vaccinated according to the EULAR recommendations. <h3>Methods</h3> The single-centre cross-sectional COLOSSeUM study was conducted in a tertiary referral centre. Between August and December 2018, all consecutive patients with AIIRD including Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), Ankylosing Spondylitis (AS) and Juvenile Idiopathic Arthritis (JIA) who visited the outpatient clinic were included. The vaccination status (influenza winter season 2017-2018, pneumococcal, tetanus toxoid and hepatitis B vaccine) and history of varicella zoster virus infection was determined using a one-page questionnaire which was completed by the treating rheumatologist after discussion with the patient. The patients' reason for non-vaccination was registered if applicable. Patients were classified as vaccinated according to the EULAR recommendations if they had a yearly influenza, an every-five-year pneumococcal and a decennial tetanus toxoid vaccine, the latter as recommended in the general population. <h3>Results</h3> The vaccination status of 633 consecutive patients was obtained. The group consisted of 489 (77.2%) patients with RA, 73 (11.5%) patients with PsA, 58 (9.2%) patients with AS and 13 (2.1%) patients with JIA with a mean ± standard deviation age of 59.8 ± 13.6, 55.8 ± 13.5, 45.2 ± 14.0 and 35.0 ± 13.9 respectively. Of all included patients with AIIRD, 69.2% were vaccinated for influenza, followed by vaccination rates of 55.0%, 32.1% and 30.5% for tetanus toxoid, pneumococcal and hepatitis B vaccination, respectively (Table 1). In addition, 70.6% of patients with AIIRD had a history of varicella zoster virus infection. Various reasons for non-vaccination were reported, of which 'No specific reason' was the most common, closely followed by non-awareness of the need for pneumococcal vaccination. The compliance with EULAR recommendations was 18.5%. Of the 429 patients with AIIRD not vaccinated according to the EULAR recommendations, 68 (15.9%) patients were not compliant with all three of the vaccines, 136 (31.7%) were not compliant with 2 vaccines (1: pneumococcal and 2: influenza or tetanus toxoid vaccine), 148 (34.5%) were not compliant with 1 vaccine (103 pneumococcal, 41 tetanus toxoid and 4 influenza vaccine) and 77 (17.9%) patients were unaware of their vaccination status for at least 1 vaccine. <h3>Conclusion</h3> In our patients with AIIRD, the highest vaccination rate for recommended vaccines was observed for influenza (nearly 70%). Not being vaccinated for pneumococcus was the main reason why patients did not comply with the EULAR recommendations. More attention is needed to determine and optimise the vaccination status of AIIRD patients and to increase the awareness regarding the pneumococcal vaccine. <h3>Disclosure of Interests:&nbsp;</h3> Delphine Bertrand: None declared, Sofie Coenen: None declared, Sofia Pazmino: None declared, Veerle Stouten: None declared, Diederik De Cock: None declared, Kristien Van der Elst: None declared, Rene Westhovens Grant/research support from: Bristol-Myers Squibb, Consultant for: Celltrion, Galapagos-Gilead, Marc Ferrante Grant/research support from: Janssen, Pfizer, Takeda, Consultant for: Abbvie, Boehringer-Ingelheim, Ferring, Janssen, Mitsubishi Tanabe, Takeda, MSD, Pfizer, Speakers bureau: Abbvie, Boehringer-Ingelheim, Chiesi, Ferring, Janssen, Lamepro, Mitsubishi Tanabe, MSD, Pfizer, Takeda, Tramedico, Tillotts, Zeria, Patrick Verschueren Grant/research support from: Unrestricted Pfizer Grant for Early RA research <b>DOI</b>: 10.1136/annrheumdis-2019-eular.3060