A multimodal intervention increases influenza vaccine uptake in rheumatoid arthritis
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BRIEF REPORT
A multimodal intervention increases influenza vaccine uptake in rheumatoid arthritis Valeria Valerio 1 & Maria Celia Bazan 1 & Mianbo Wang 2 & Bruce D. Mazer 1 & Christian A. Pineau 3 & Elizabeth M. Hazel 3 & Sasha Bernatsky 3,4 & Brian J. Ward 1,5 & Ines Colmegna 1,3 Received: 23 August 2020 / Revised: 25 September 2020 / Accepted: 28 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Annual influenza vaccination is recommended for patients with rheumatoid arthritis (RA), but coverage is suboptimal. We assessed the impact of an implementation strategy in enhancing vaccination uptake in RA. We evaluated a multimodal implementation strategy at rheumatology clinics that included 3 approaches: patient recalls, a nurse providing vaccines, and physician reminders. We compared patient-reported vaccination rates after implementation with those reported before the implementation strategy in a nonequivalent control group. In multivariate analyses, we assessed factors potentially associated with influenza vaccine uptake. One hundred and sixteen RA patients were vaccinated during the intervention. The influenza vaccination rate in RA increased from 48.5% (65/136) before implementation to 62.6% (67/107) after implementation (difference of 14.1, 95% CI 1.5, 26.1). In multivariate analyses, older age, biologics use, and physician recommendation for vaccination were associated with influenza vaccine uptake. A multimodal intervention was associated with increased influenza vaccine coverage among RA patients. Older patients and those on biologics were more likely to be immunized against influenza. Physician’s recommendations are important to promote vaccine coverage. Key Points • Despite current recommendations, influenza vaccine uptake among rheumatoid arthritis (RA) patients is suboptimal. • A multimodal implementation strategy facilitating access to influenza vaccine and raising awareness through vaccination reminders improved immunization uptake in RA. • Physicians play a key role in promoting annual seasonal influenza vaccination. • The reasons for vaccine hesitancy in RA should be addressed to reach a vaccination target of 80% required to reduce the burden of this preventable infection.
Keywords Influenza . Rheumatoid arthritis . Vaccine coverage . Vaccine uptake . Vaccines
Part of this manuscript was presented at the 2019 American College of Rheumatology Annual Meeting. Reference: Valerio V, Bazan M, Wang M, Mazer B, Hazel E, Pineau C, Bernatsky S, Ward B, Colmegna I. An Intervention Bundle Increases Uptake of Influenza Vaccine by Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/an-intervention-bundleincreases-uptake-of-influenza-vaccine-by-rheumatoid-arthritis-patients/. Accessed August 20, 2020. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10067-020-05435-3) contains supplementary material, which is available to authorized users. * Ines Colmegna ine
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