DESTIN, Fla. — National and international vaccination recommendations for patients with systemic lupus erythematosus have been insufficiently implemented, with less than 30% receiving annual influenza vaccines and half failing to receive any pneumococcal vaccine, according to data presented at the 2019 North American Young Rheumatology Investigator Forum.
“We all know that one of the most common causes of death in patients with systemic lupus erythematosus is infection, and vaccination may improve outcomes in such patients,” Anam Umar, MD, of the Morehouse School of Medicine, Atlanta, told attendees. “The Advisory Committee on Immunization Practices recommends annual influenza vaccine for all SLE patients, and they also recommend pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine for patients who are on immunosuppressive medications. However, our initial reviews suggest that despite these recommendations, vaccine rates continue to be suboptimal.”
To analyze vaccination rates among patients with SLE, Umar and colleagues gathered and reviewed medical record data from one of the outpatient departments at Grady Memorial Hospital in Atlanta, dated between May 2017 and June 2018. A total of 128 patients with SLE were identified and included in the study.
National and international vaccination recommendations for patients with SLE have been insufficiently implemented, according to data.
The researchers collected data on influenza and pneumococcal vaccines, as well as any prescribed immunosuppressive drugs. In addition, comorbidities considered in the final analysis included asthma, chronic obstructive pulmonary disease, kidney diseases, diabetes mellitus, coronary artery disease and HIV/AIDS.
According to Umar, 43.7% of patients included in the study were being treated with immunosuppressant medications, including azathioprine, mycophenolate, methotrexate, cyclosporine and prednisone. Among the full, 128-patient study population, 28.91% received an annual influenza vaccine, and 50% had received any pneumococcal vaccine. Just 16% of patients received both pneumococcal conjugate and pneumococcal polysaccharide vaccines. Patients aged 50 years and older were more likely to have the influenza vaccine compared with younger patients (P = .022).
In addition, patients with other comorbidities were more likely to receive influenza (P = .002) and pneumonia (P = .005) vaccines compared with those with lupus only.
“We propose that education on the national and international vaccination guidelines should be provided to physicians and residents involved in the care of these patients,” Umar said. “We also propose that we should incorporate reminder alerts and patient education materials regarding vaccination guidelines in the electronic medical record system, which might improve the uptake and rate.” – by Jason Laday
Umar A. Influenza and pneumococcal vaccines in patients with systemic lupus erythematosus: Findings from a large urban public hospital. Presented at: North American Young Rheumatology Investigator Forum; May 1, 2019; Destin, Fla.
Disclosure: Umar reports no relevant financial disclosures.