Evaluation of pneumococcal and influenza vaccination coverage in rheumatology patients receiving biological therapy in a regional referral hospital

Reumatol Clin (Engl Ed). 2020 Mar-Apr;16(2 Pt 1):97-102. doi: 10.1016/j.reuma.2018.03.009. Epub 2018 May 8.
[Article in English, Spanish]


Objective: Vaccination coverage for seasonal influenza and pneumococcus in rheumatology patients receiving biological treatment. To identify variables that predict vaccination adherence.

Material and method: Descriptive cross-sectional study. The study involved rheumatology patients who initiated biological therapy between 01/01/2016 and 12/31/2016 in a regional referral hospital. Variables included sociodemographic information, diagnostic data, treating physician, referral to the vaccine unit and vaccination against pneumococcus with 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23), as well as seasonal influenza (2016/17). Univariate, bivariate (Chi-square) and multivariate analysis (logistic regression) were performed. The differences were considered significant (P<.05) and the PASW v.18 software package was used.

Results: In all, 222 patients were included. Vaccination coverage was: PCV13, 80.2%; PPSV23, 77.9%; influenza 2016/17, 78.8%; PCV13+PPSV23, 75.2%; PCV13+PPSV23+influenza 2016/17, 68.9%. Axial spondylitis had the highest coverage (>80%) for pneumococcal vaccination and combination of pneumococcal with influenza. Overall, 27% of the patients were not referred to the unit. The treating physician was associated with statistical significance in each vaccine alone or combined, but referral to the vaccine unit was independently associated with the highest vaccination coverage (P<.001) in all cases.

Conclusions: Compared to the scientific literature, we consider that the coverage of our patients against pneumococcus and influenza is high. Referral of these patients to the vaccine unit is the key to guarantee a correct immunization and to minimize some of the possible infectious adverse effects of biological therapies.

Keywords: Biological therapy; Gripe; Influenza; Neumococo; Pneumococcus; Terapia biológica; Vaccine; Vacuna.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Therapy*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunocompromised Host
  • Influenza Vaccines*
  • Influenza, Human / immunology
  • Influenza, Human / prevention & control*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data
  • Pneumococcal Infections / immunology
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines*
  • Referral and Consultation
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy
  • Rheumatic Diseases / immunology
  • Vaccination Coverage / statistics & numerical data*


  • Influenza Vaccines
  • Pneumococcal Vaccines