Department of Rheumatology, Cork University Hospital, Cork, Ireland.
Joint Bone Spine. 2011 Jul;78(4):374-7. doi: 10.1016/j.jbspin.2010.10.012. Epub 2010 Dec 18.
The patients using immunosuppressive agents are considered at high risk for acquiring different infections. Accordingly, international guidelines recommend vaccinating such patients against influenza and pneumococcal organisms. The aims of this study were two-fold: (1) to assess the influenza and pneumococcal vaccination uptake among our rheumatology outpatients who are immunosuppressed; (2) to identify the factors influencing immunisation uptake among our sample of patients.
This was a questionnaire-based study. Patients were eligible to partake in this study if they were using immunosuppressive drugs. During the study period (4 weeks), 337 patients were screened, and 110 patients fulfilled the criteria for inclusion.
Positive vaccination uptake of our cohort was as follows: common influenza alone (34%, 37 out of 110), pneumonia alone (11%, 12 out of 110), and both pneumococcal and influenza vaccination (11%). The status of influenza A (H1N1) vaccination was not recorded as a part of this audit. The two most common reasons cited by patients for non-uptake of vaccinations were: 'not offered' and 'thought it was unnecessary'. Of 37 patients who had influenza vaccination, 33 patients (89%) had additional risk factors, and there were only four patients who had influenza vaccine solely because they were taking immunosuppressive drugs. All pneumococcal vaccinated patients (n=12) were noted to have additional risk factors.
There is suboptimal uptake of influenza and pneumococcal vaccinations among immunosuppressed patients attending rheumatology outpatient clinics. These results are a cause of concern given the morbidity and mortality of associated infections.
使用免疫抑制剂的患者被认为具有获得各种感染的高风险。因此,国际指南建议对这些患者进行流感和肺炎球菌疫苗接种。本研究的目的有两个:(1)评估我们免疫抑制的风湿病门诊患者接种流感和肺炎球菌疫苗的情况;(2)确定影响我们患者样本免疫接种的因素。
这是一项基于问卷调查的研究。如果患者正在使用免疫抑制剂,则有资格参加本研究。在研究期间(4 周),共筛查了 337 名患者,有 110 名患者符合纳入标准。
我们队列的疫苗接种阳性率如下:单独接种普通流感疫苗(34%,110 例中有 37 例)、单独接种肺炎疫苗(11%,110 例中有 12 例)、以及同时接种肺炎球菌疫苗和流感疫苗(11%)。本次审核未记录流感 A(H1N1)疫苗的接种情况。患者未接种疫苗的两个最常见原因是:“未提供”和“认为没有必要”。在接种流感疫苗的 37 名患者中,有 33 名(89%)患者有其他危险因素,仅有 4 名患者因正在服用免疫抑制剂而单独接种流感疫苗。所有接种肺炎球菌疫苗的患者(n=12)都有其他危险因素。
在接受风湿病门诊治疗的免疫抑制患者中,流感和肺炎球菌疫苗的接种率不理想。鉴于相关感染的发病率和死亡率,这些结果令人担忧。