Coverage and Effectiveness of Influenza and Pneumococcal Immunization in Autoimmune Inflammatory Rheumatic Disease Patients: A Cross-sectional Study

Introduction: Patients with Autoimmune Inflammatory Rheumatic Disease (AIIRD) are at an increased risk of developing infectious diseases. Vaccination is recommended for these patients by various societies as a preventive strategy. Despite this, the coverage of vaccination is exceedingly low, especially in developing countries. Aim: To estimate the coverage of pneumococcal and influenza vaccinations, as well as Vaccine Effectiveness (VE). Materials and Methods: This was a cross-sectional study conducted over a duration of one year, from December 2021 to December 2022, in the Department of Internal Medicine and Allied Specialties at the Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India. All consenting AIIRD patients aged over 18 years were enrolled in the outpatient department of Internal Medicine and Allied Specialties at SKIMS, Srinagar, Jammu and Kashmir, India. A history of seasonal influenza and pneumococcal vaccinations was obtained. The coverage of vaccination was determined, and patients were followed-up over a period of one year to assess VE. The Chi-square test was used for comparing categorical values, with a p-value of <0.05 considered significant. Results: This study included 438 patients, of which 348 (79.5%) were females and 90 (20.5%) were males. The mean age of the study population was 38 +/- 11.8 years. Out of 438 patients, only 100 (22.8%) were vaccinated against influenza, while a total of 90 (20.5%) patients had received one or more doses of pneumococcal vaccines. The incidence of symptomatic influenza and pneumococcal pneumonia was higher in the unvaccinated groups. Both vaccines were found to be safe and effective, with a VE of 73.21% for the influenza vaccine and 65.26% for the pneumococcal vaccine. Conclusion: Present study reveals an overall low coverage of these vaccinations among patients with AIIRD in the region, which needs to be addressed. The findings indicate that influenza and pneumococcal vaccines are safe and effective for patients with AIIRD.