The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics

Joint Bone Spine. 2011 Jul;78(4):374-7. doi: 10.1016/j.jbspin.2010.10.012. Epub 2010 Dec 18.


Purpose and objectives: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

MeSH terms

  • Cohort Studies
  • Female
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / therapeutic use
  • Influenza Vaccines / administration & dosage*
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pneumococcal Vaccines / administration & dosage*
  • Rheumatic Diseases / drug therapy
  • Rheumatic Diseases / immunology*
  • Surveys and Questionnaires
  • Treatment Refusal
  • Vaccination / statistics & numerical data*


  • Immunosuppressive Agents
  • Influenza Vaccines
  • Pneumococcal Vaccines