AB1158 VACCINATION BARRIERS IN PATIENTS WITH RHEUMATIC DISEASES
Authors: G. Figueroa-Parra, A. Moreno-Salinas, L. Santoyo-Fexas, C. M. Gamboa-Alonso, A. L. De-Leon-Ibarra, I. D. J. Hernandez-Galarza, D. Á. Galarza-Delgado, J. A. Esquivel Valerio
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with rheumatic diseases (RD) are at increased risk of infections, attributed to the underlying RD, comorbidities and immunosuppressive therapy, including glucocorticoids, disease-modifying antirheumatic drugs, etc. (1). While many infectious diseases can generally be prevented by vaccines, immunization rates in this specific patient population remain suboptimal (2). Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs (3). Objectives: To describe the main causes of non-vaccination in patients with RD. Methods: A self-questionnaire was applied to a sample of patients with RD in the rheumatology clinic of the university hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico between September and December 2019. The questionnaire evaluated demographic characteristics (age, gender, diagnosis) and the vaccination status for Influenza (last year), pneumococcal (last 5 years), Herpes zoster (ever), Human papillomavirus (any dose) and Hepatitis B (any dose). It also includes a question asking: If you didn’t receive any of the previous vaccines, what was the reason? (multiple-choice are shown in Table 2). Results are shown in frequencies and percentages. Table 2. Vaccination barriers N=82 If you didn’t receive any of the previous vaccines, what was the reason? n (%) 1)Did not was recommended 22 (26.8) 2) Lack of availability 21 (25.6) 3) Vaccines don’t work 13 (15.8) 4) Fear of adverse events 8 (9.7) 5) Previous adverse event 3 (3.6) 6) Other reason - Own decision 8 (9.7) - Disinformation 7 (8.5) Results: 102 patients were evaluated: Mean age was 51.27 (SD 14.68) years; 84 (82.4%) were females; 71 (69.6%) had rheumatoid arthritis, 13 (12.7%) had systemic lupus erythematosus, 6 (5.8%) had other autoimmune diseases and 12 (11.8%) had osteoarthritis. The rate of vaccination for Influenza was 49 (48%), for pneumococcal 25 (24.5%), for Herpes zoster 5 (4.9%), for Human papillomavirus 9 (8.8%), for Hepatitis B 14 (13.7%) (Table 1). 82 (80.3%) patients reported some barriers in vaccination, from these: 22 (26.8%) did not get the recommendation from the rheumatologist, 21 (25.6%) did not found available the vaccine, 13 (15.8%) believes that vaccines don’t work, 8 (9.7%) had fear of adverse events, 3 (3.6%) reported previous adverse events, and 15 (18.2%) reported other reasons, that we classified as own decision 8 (9.7%) and disinformation 7 (8.5%) (Table 2). Table 1. Demographic characteristics N= 102 Age, years, mean (SD) 51.27 (14.68) Female, n (%) 84 (82.4) Diagnosis, n (%) -RA 71 (69.6) -SLE 13 (12.7) -OA 12 (11.8) -Other AID 6 (5.8) Conclusion: The main barriers in vaccination of rheumatic patients reported were the lack of availability of the indicated vaccines and the medical and patient disinformation. This problem must be combated to ensure the complete vaccination of rheumatic patients. References: [1]Ann Rheum Dis. 2020;79:39-52. [2]J Rheumatol. 2019;46(7):751-754 [3]Hum Vaccin Immunother. 2013;9(8):1763-73. Disclosure of Interests: None declared