Pneumococcal vaccine uptake in patients with inflammatory arthritis: a single centre cohort study.

Objectives: Current guidelines recommend pneumococcal vaccination in individuals who are over the age of 65 or are immunosuppressed due to a disease or treatment. The objective of this study was to assess vaccine uptake rates in people with inflammatory arthritis for the pneumococcal, influenza and Covid-19 vaccines and factors determining uptake.

Methods: We conducted a retrospective single centre cohort study in the UK of individuals with rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis between October and December 2023. Data were collected for age, gender, co-morbidities, immunosuppressive therapies and dates of vaccines. Logistic regression was used to evaluate predictors of vaccine uptake, with adjustments for demographic and clinical factors.

Results: Nine hundred and six individuals were identified; 46% were receiving treatment with conventional synthetic DMARD (csDMARD), 26% were on biologic monotherapy, and 23% were on both biologic and csDMARDs. Three hundred and sixteen individuals (35%) received a pneumococcal vaccine, lower than uptake for influenza (63%) and Covid-19 (87%) vaccines. Predictors of pneumococcal vaccine uptake included age, with older patients more likely to be vaccinated (odds ratio [OR] for age ≥ 65 years: 1.67; 95% CI: 1.21, 2.29). Those on biologic therapy demonstrated higher likelihood of vaccination (OR for biologic therapy: 1.81; 95% CI: 1.33, 2.47). Additional Joint Committee on Vaccination and Immunisation Green Book indicators also positively influenced vaccine uptake (OR: 1.67; 95% CI: 1.19, 2.33).

Conclusion: Pneumococcal vaccine uptake in inflammatory rheumatic diseases is low, especially in younger patients and those not on biologic therapy. The study highlights the need for a focused approach, distinct from strategies for other vaccines, to address this public health challenge.