Vaccination rates in rheumatic diseases: a cross-sectional register study on the role of patient beliefs and physician engagement.

Abstract

To evaluate the vaccination attitude and behaviour of patients with autoimmune inflammatory rheumatic diseases (AIIRD), and identify factors associated with vaccination status, utilizing data from a national register. A cross-sectional survey was developed to assess behaviour around vaccination of patients with AIIRD, nested within the Swiss Clinical Quality Management (SCQM) register. The primary outcome was vaccination uptake evaluated through three parameters: checking vaccination status (i.e. ensuring that vaccinations were checked by a health professional), influenza and pneumococcal vaccination coverage. The main exposure evaluated was patient's beliefs about vaccination importance and safety. Vaccination uptake was analysed using descriptive statistics, and associations with exposures using logistic regression. Missing data were imputed by multiple imputation, and multivariable analyses were adjusted for age, gender, body mass index, disease type, disease duration, treatment. Of 2446 patients (59% women, 79% <65 years old) included, 52% believed in both the importance and safety of vaccine and 2% believed both that vaccination was neither safe nor important. Most patients (64%) reported no change in their vaccination beliefs after the COVID-19 pandemic. Among respondents, 48% had checked their vaccination status in the past 24 months, 51% reported vaccination against influenza and 33% against pneumococcal pneumonia. Discussions with the rheumatologist about vaccination during follow-up or before initiating treatment were positively associated with vaccination. Vaccination uptake was relatively low in this vulnerable population. Strategies promoting discussion with the rheumatologist about vaccination and before treatment could play a pivotal role in improving vaccination uptake among patients with AIIRD.