Vaccination coverage in systemic lupus erythematosus-a cross-sectional analysis of the German long-term study (LuLa cohort)

• Published in: Rheumatology (Oxford, England) Vol. 57; no. 8; pp. 1439 - 1447
• Main Authors: Chehab, Gamal, Richter, Jutta G, Brinks, Ralph, Fischer-Betz, Rebecca, Winkler-Rohlfing, Borgi, Schneider, Matthias
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2018; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Clinical trials; Cohort analysis; Cross-Sectional Studies; Demography; Female; Follow-Up Studies; Germany - epidemiology; Humans; Immunization; Immunocompetence; Immunocompromised hosts; Incidence; Influenza; Influenza Vaccines; Influenza, Human - epidemiology; Influenza, Human - etiology; Influenza, Human - prevention & control; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - epidemiology; Lupus Erythematosus, Systemic - immunology; Male; Middle Aged; Pneumococcal Infections - epidemiology; Pneumococcal Infections - prevention & control; Pneumococcal Vaccines; Quality of care; Retrospective Studies; Surveys and Questionnaires; Systemic lupus erythematosus; Tetanus; Time Factors; Vaccination - statistics & numerical data; Vaccination Coverage - statistics & numerical data; Vaccines; Young Adult; systemic lupus erythematosus; cohort study; quality of care; preventive care; vaccination
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/key120

Abstract Objectives Vaccinations are an important measure to prevent infections in immunocompromised patients. The knowledge of vaccination coverage and reasons for non-vaccination in patients with SLE is scarce. The aim of this study was to assess coverage rates of selected vaccinations in a representative sample of SLE patients and to identify predictors for non-vaccination. Methods In 2013, information on selected vaccinations (coverage, application and reservations) and on demographics, clinical parameters and health beliefs was assessed by means of a self-reported questionnaire among a representative sample of SLE patients in Germany (LuLa cohort). Results Five hundred and seventy-nine patients participated. Vaccination status was primarily checked by their general practitioner (57.3%). Of all the patients, 24.9% did not get their vaccination status checked at all, 16.1% had generally been advised against the use of vaccinations by a physician, and 37.5% stated that they had rejected vaccinations themselves. Their main reasons were fears of developing a lupus flare (21.8%) or adverse events (13.5%). A greater belief by patients in the doctor controlling one's health and the general benefit of medication prevented the rejection of vaccines. Vaccination coverage was low for all recorded vaccinations (tetanus 65.8%, influenza 45.2%, pneumococcus 32.2% and meningococcus 6.1%). Older age was predictive of receiving influenza and pneumococcal vaccination. The same applies for CSs >7.5 mg for receiving influenza vaccination. Conclusion Vaccination coverage in SLE patients is poor and reflects insufficient implementation of national and international recommendations. Rheumatologists need to recognize patients' reservations against vaccinations, to communicate their importance and safety and to give individual recommendations to patients and their health-care providers. Trial registration German Clinical Trials Register, www.germanctr.de, DRKS00011052.