Division of Rheumatology, Department of Medicine, McGill University.
Research Institute of the McGill University Health Centre.
Rheumatology (Oxford). 2021 Nov 3;60(11):5257-5270. doi: 10.1093/rheumatology/keab471.
Immunization is an essential component of RA care. Nevertheless, vaccine coverage in RA is suboptimal. Contextual, individual and vaccine-related factors influence vaccine acceptance. However, barriers and facilitators of vaccination in RA are not well defined. The aim of this study was to assess perspectives of RA patients and healthcare professionals (HCPs) involved in RA care of barriers and facilitators regarding influenza and pneumococcal vaccines.
Eight focus groups (four with RA patients and four with HCPs) and eight semi-structured open-ended individual interviews with vaccine-hesitant RA patients were conducted. Data were audio recorded, transcribed verbatim and imported to MAXQDA software. Analysis using the framework of vaccine hesitancy proposed by the Strategic Advisory Group of Experts on Immunization was conducted.
RA patients and HCPs reported common and specific barriers and facilitators to influenza vaccination that included contextual, individual and/or group and vaccine- and/or vaccination-specific factors. A key contextual influence on vaccination was patients' perception of the media, pharmaceutical industry, authorities, scientists and the medical community at large. Among the individual-related influences, experiences with vaccination, knowledge/awareness and beliefs about health and disease prevention were considered to impact vaccine acceptance. Vaccine-related factors including concerns about vaccine side effects such as RA flares, the safety of new formulations, the mechanism of action, access to vaccines and costs associated with vaccination were identified as actionable barriers.
Acknowledging RA patients' perceived barriers to influenza and pneumococcal vaccination and implementing specific strategies to address them might increase vaccination coverage in this population.
免疫接种是类风湿关节炎（RA）治疗的重要组成部分。然而，RA 患者的疫苗接种率并不理想。背景、个体和疫苗相关因素影响疫苗的可接受性。但是，RA 患者接种疫苗的障碍和促进因素尚不清楚。本研究旨在评估参与 RA 治疗的患者和医疗保健专业人员（HCP）对流感和肺炎球菌疫苗接种的看法，评估其对流感和肺炎球菌疫苗接种的障碍和促进因素。
进行了 8 个焦点小组（4 个 RA 患者组和 4 个 HCP 组）和 8 个对流感疫苗犹豫不决的 RA 患者的半结构式开放式个人访谈。将数据进行音频录制、逐字转录并导入 MAXQDA 软件。使用免疫接种战略咨询专家组提出的疫苗犹豫框架进行分析。
RA 患者和 HCP 报告了常见和特定的流感疫苗接种障碍和促进因素，包括背景、个体和/或群体以及疫苗和/或疫苗接种特异性因素。对疫苗接种有重要影响的背景因素是患者对媒体、制药行业、当局、科学家和整个医学界的看法。在个体相关影响因素中，接种疫苗的经验、对健康和疾病预防的知识/意识和信念被认为会影响疫苗的接受度。疫苗相关因素包括对疫苗副作用（如 RA 发作）、新配方的安全性、作用机制、疫苗获取以及与疫苗接种相关的费用的担忧，这些被认为是可采取的障碍。
认识到 RA 患者对流感和肺炎球菌疫苗接种的感知障碍，并实施具体策略来解决这些障碍，可能会提高这一人群的疫苗接种率。
