Skip to main content

Advertisement

SpringerLink
Log in

Adoption rates of recommended vaccines and influencing factors among patients with inflammatory arthritis: a patient survey

  • Patient Opinion
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

To determine the scope of recommended vaccination uptake among patients with inflammatory arthritis (IA) receiving biologic and targeted synthetic disease-modifying antirheumatic agents (bDMARDs and tsDMARDs, respectively) and to determine factors, which influence their decision and are subject to modification. A single-center, cross-sectional study was conducted including patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) on bDMARDs or tsDMARDs. Demographic, anthropometric, and clinical parameters were analyzed. Disease activity was determined using the validated indices DAS28-CRP and CDAI for RA and peripheral PsA, whereas BASDAI and ASDAS for AS and axial PsA. Patients completed a questionnaire with predefined response options assessing their vaccination status and attitudes about receiving a COVID-19 vaccination. A total of 201 patients with inflammatory joint diseases were included in the study, with a mean age of 54.6 (± 8.6) years and a disease duration of 11 (± 14.4) years. More than one-third of the study group had received full vaccination against SARS-CoV-2, with the majority (68.1%) receiving the BNT162b2 vaccine. The proportion of patients who had received recommended pneumococcal and influenza vaccinations and regular reimmunizations against diphtheria and tetanus was low, with only 13.9% (n = 28), 1.5% (n = 3), and 44.8% (n = 90), respectively. Patients who had a preceding discussions with a rheumatologist were more likely to get vaccinated. Considering the suboptimal vaccination rates and the prevalent uncertainty among individuals with IA in Bulgaria, there is an urgent need to devise novel strategies to promote vaccination uptake and enhance patient awareness. These strategies aim to educate patients about their autoimmune condition, as well as emphasize the safety and efficacy of vaccines.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

Upon request to the corresponding author, non-confidential data can be shared on a reasonable basis.

References

  1. van Onna M, Boonen A (2022) Challenges in the management of older patients with inflammatory rheumatic diseases. Nat Rev Rheumatol 18:326–334

    Article  PubMed  Google Scholar 

  2. Bournia V-K, Fragoulis GE, Mitrou P et al (2021) All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015–2019. RMD Open. https://doi.org/10.1136/rmdopen-2021-001694

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ahmed S, Gasparyan AY, Zimba O (2021) Comorbidities in rheumatic diseases need special consideration during the COVID-19 pandemic. Rheumatol Int 41:243–256

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Hsu C-Y, Ko C-H, Wang J-L et al (2019) Comparing the burdens of opportunistic infections among patients with systemic rheumatic diseases: a nationally representative cohort study. Arthritis Res Ther 21:1–10

    Article  CAS  Google Scholar 

  5. Mehta P, Gasparyan AY, Zimba O, Kitas GD (2022) Systemic lupus erythematosus in the light of the COVID-19 pandemic: infection, vaccination, and impact on disease management. Clin Rheumatol 41:2893–2910

    Article  PubMed  PubMed Central  Google Scholar 

  6. Velikova T, Georgiev T (2021) SARS-CoV-2 vaccines and autoimmune diseases amidst the COVID-19 crisis. Rheumatol Int 41:509–518

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Landewé RBM, Kroon FPB, Alunno A et al (2022) EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update. Ann Rheum Dis 81:1628–1639

    Article  PubMed  Google Scholar 

  8. Furer V, Rondaan C, Heijstek MW et al (2020) 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 79:39–52

    Article  PubMed  CAS  Google Scholar 

  9. Furer V, Rondaan C, Heijstek M et al (2019) Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. RMD Open 5:e001041

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rondaan C, Furer V, Heijstek MW et al (2019) Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations. RMD Open 5:e001035

    Article  PubMed  PubMed Central  Google Scholar 

  11. Machado PM, Lawson-Tovey S, Strangfeld A et al (2022) Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry. Ann Rheum Dis 81:695–709

    Article  PubMed  CAS  Google Scholar 

  12. Péntek M, Poór G, Wiland P et al (2014) Biological therapy in inflammatory rheumatic diseases: issues in Central and Eastern European countries. Eur J Health Econ 15:35–43

    Article  Google Scholar 

  13. Gaur PS, Zimba O, Agarwal V, Gupta L (2020) Reporting survey based studies - a primer for authors. J Korean Med Sci 35:e398

    Article  PubMed  PubMed Central  Google Scholar 

  14. Doran MF, Crowson CS, Pond GR et al (2002) Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study. Arthritis Rheum 46:2287–2293

    Article  PubMed  Google Scholar 

  15. Singer D, Thompson-Leduc P, Poston S et al (2023) Incidence of herpes zoster in patients with rheumatoid arthritis in the United States: a retrospective cohort study. J Rheumatol. https://doi.org/10.3899/jrheum.220986

    Article  PubMed  Google Scholar 

  16. Gaur P, Agrawat H, Shukla A (2021) COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey. Rheumatol Int 41:1601–1605

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Boekel L, Hooijberg F, van Kempen ZLE et al (2021) Perspective of patients with autoimmune diseases on COVID-19 vaccination. Lancet Rheumatol 3:e241–e243

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Harrison N, Poeppl W, Miksch M et al (2018) Predictors for influenza vaccine acceptance among patients with inflammatory rheumatic diseases. Vaccine 36:4875–4879

    Article  PubMed  Google Scholar 

  19. Ten health issues WHO will tackle this year. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Accessed 10 May 2023

  20. Fajar JK, Sallam M, Soegiarto G et al (2022) Global Prevalence and potential influencing factors of COVID-19 vaccination hesitancy: a meta-analysis. Vaccines (Basel). https://doi.org/10.3390/vaccines10081356

    Article  PubMed  Google Scholar 

  21. Manrique de Lara A, Colmenares-Roa T, Pascual-Ramos V et al (2023) Sociocultural and moral narratives influencing the decision to vaccinate among rheumatic disease patients: a qualitative study. Clin Rheumatol. https://doi.org/10.1007/s10067-023-06609-5

    Article  PubMed  PubMed Central  Google Scholar 

  22. Mv P, Auanassova A, Yessirkepov M et al (2023) New-onset systemic vasculitis following SARS-CoV-2 infection and vaccination: the trigger, phenotype, and outcome. Clin Rheumatol 42:2761–2775

    Article  PubMed  Google Scholar 

  23. Fan G, Song H, Yip S et al (2022) Impact of low vaccine coverage on the resurgence of COVID-19 in Central and Eastern Europe. One Health 14:100402

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  24. Moskova M, Zasheva A, Kunchev M et al (2022) Students’ attitudes toward COVID-19 vaccination: an inter-University Study from Bulgaria. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph19169779

    Article  PubMed  PubMed Central  Google Scholar 

  25. Felten R, Dubois M, Ugarte-Gil MF et al (2021) Vaccination against COVID-19: expectations and concerns of patients with autoimmune and rheumatic diseases. Lancet Rheumatol 3:e243–e245

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Yurttas B, Poyraz BC, Sut N et al (2021) Willingness to get the COVID-19 vaccine among patients with rheumatic diseases, healthcare workers and general population in Turkey: a web-based survey. Rheumatol Int 41:1105–1114

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Godoy P, Castilla J, Mayoral JM et al (2015) Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study. BMC Fam Pract 16:44

    Article  PubMed  PubMed Central  Google Scholar 

  28. Peterson CJ, Lee B, Nugent K (2022) COVID-19 vaccination hesitancy among healthcare workers—a review. Vaccines 10:948

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Fathi HM, Gazzar IIE, Elazeem MIA et al (2022) Rheumatologists’ knowledge and perception of COVID-19 and related vaccines: the vaXurvey2 online survey. Rheumatol Int 42:989–998

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Kiltz U, Celik A, Tsiami S et al (2021) Are patients with rheumatic diseases on immunosuppressive therapies protected against preventable infections? A cross-sectional cohort study. RMD Open. https://doi.org/10.1136/rmdopen-2020-001499

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Elements of this study were presented during the Annual European Congress of Rheumatology in 2022 and 2023 and can be found in the form of abstracts: http://doi.org/10.1136/annrheumdis-2022-eular.4447 and http://doi.org/10.1136/annrheumdis-2023-eular.4871, respectively.

Author information

Authors and Affiliations

  1. Clinic of Rheumatology, University Hospital St. Marina, 9010, Varna, Bulgaria

    Rosina Moraliyska, Tsvetoslav Georgiev, Simona Bogdanova-Petrova & Tanya Shivacheva

  2. Department of Clinical Medical Sciences, Faculty of Dentistry, Medical University-Varna, 9002, Varna, Bulgaria

    Rosina Moraliyska

  3. First Department of Internal Medicine, Faculty of Medicine, Medical University-Varna, 9002, Varna, Bulgaria

    Tsvetoslav Georgiev, Simona Bogdanova-Petrova & Tanya Shivacheva

Authors
  1. Rosina Moraliyska
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsvetoslav Georgiev
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simona Bogdanova-Petrova
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tanya Shivacheva
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RM and TG conceived the presented idea. TG developed the theory, whereas RM and SB obtained the data from the utilized interview and questionnaire. TG, TS, and SB verified the analytical methods. TG and TS encouraged RM to investigate the adoption rates of recommended vaccines and supervised the findings of this work. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Tsvetoslav Georgiev.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

A written informed consent was signed by each patient in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 169 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moraliyska, R., Georgiev, T., Bogdanova-Petrova, S. et al. Adoption rates of recommended vaccines and influencing factors among patients with inflammatory arthritis: a patient survey. Rheumatol Int 44, 165–172 (2024). https://doi.org/10.1007/s00296-023-05476-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-023-05476-2

Keywords

Search

Navigation