Krasselt Marco, Wagner Ulf, Seifert Olga
Medical Clinic III, Endocrinology, Nephrology and Rheumatology, Leipzig University, Liebigstr. 20, 04103 Leipzig, Germany.
Vaccines (Basel). 2023 Mar 29;11(4):760. doi: 10.3390/vaccines11040760.
Vaccination rates are known to be low in patients with autoimmune inflammatory rheumatic diseases (AIIRD). We therefore aimed to determine current vaccination rates against influenza, Streptococcus pneumoniae and herpes zoster in a cohort of patients with AIIRD in Germany.
Consecutive adult patients with an AIIRD were recruited from our outpatient clinic during their regular consultations. The individual vaccination status regarding influenza, Streptococcus pneumoniae and herpes zoster was obtained by reviewing the vaccination documents.
A total of 222 AIIRD patients (mean age 62.9 ± 13.9 years) were included. In total, 68.5% were vaccinated against influenza, 34.7% against Streptococcus pneumoniae and 13.1% against herpes zoster (HZ). The pneumococcal vaccination was outdated in 29.4% of the vaccinated patients. Vaccination rates were significantly higher in patients ≥60 years old (odds ratio (OR) 2.167, 95% confidence interval (CI) 1.213-3.870, = 0.008 for influenza, OR 4.639, 95% CI 2.555-8.422, < 0.0001 for pneumococcal and OR 6.059, 95% CI 1.772-20.712, = 0.001 for HZ vaccination). Ages > 60 years, female sex, glucocorticoid use and influenza vaccination were all independently associated with a pneumococcal vaccination. Regarding influenza vaccination, only a positive pneumococcal vaccination history remained independently associated. In patients with HZ vaccination, glucocorticoid use and a preceding pneumococcal vaccination were independently associated with HZ protection.
The frequencies of vaccinations against influenza, Streptococcus pneumoniae and HZ have increased during recent years. While this can be partly explained by continuous efforts in patient education during the outpatient visits, the COVID-19 pandemic might also have contributed. Nevertheless, the persistently high incidence and mortality of these preventable diseases in patients with AIIRDs mandates further efforts to increase vaccination coverage, particularly in SLE patients.
已知自身免疫性炎性风湿病（AIIRD）患者的疫苗接种率较低。因此，我们旨在确定德国一组AIIRD患者目前针对流感、肺炎链球菌和带状疱疹的疫苗接种率。
在门诊定期会诊期间，从我们的门诊招募连续的成年AIIRD患者。通过查阅疫苗接种文件获取个体关于流感、肺炎链球菌和带状疱疹的疫苗接种状况。
共纳入222例AIIRD患者（平均年龄62.9±13.9岁）。总体而言，68.5%的患者接种了流感疫苗，34.7%接种了肺炎链球菌疫苗，13.1%接种了带状疱疹（HZ）疫苗。29.4%接种肺炎链球菌疫苗的患者接种时间已过时。≥60岁患者的疫苗接种率显著更高（流感疫苗接种的优势比（OR）为2.167，95%置信区间（CI）为1.213 - 3.870，P = 0.008；肺炎链球菌疫苗接种的OR为4.639，95% CI为2.555 - 8.422，P < 0.0001；HZ疫苗接种的OR为6.059，95% CI为1.772 - 20.712，P = 0.001）。年龄>60岁、女性、使用糖皮质激素和接种流感疫苗均与接种肺炎链球菌疫苗独立相关。关于流感疫苗接种，仅肺炎链球菌疫苗接种史阳性与之独立相关。在接种HZ疫苗的患者中，使用糖皮质激素和先前接种肺炎链球菌疫苗与HZ疫苗保护独立相关。
近年来，针对流感、肺炎链球菌和HZ的疫苗接种频率有所增加。虽然这部分可以通过门诊就诊期间持续的患者教育努力来解释，但COVID - 19大流行可能也起到了作用。尽管如此，AIIRD患者中这些可预防疾病持续居高不下的发病率和死亡率要求进一步努力提高疫苗接种覆盖率，尤其是在系统性红斑狼疮患者中。
