Nakafero, G, Grainge, MJ, Myles, PR, Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028, Zhang, W, Doherty, M, Nguyen-Van-Tam, JS and Abhishek, A (2019) Association between inactivated influenza vaccine and primary care consultations for autoimmune rheumatic disease flares: a self-controlled case series study using data from the Clinical Practice Research Datalink. Annals of the Rheumatic Diseases, 78 (8). 1122 - 1126.

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Abstract

Objectives:
To examine the association between inactivated influenza vaccine (IIV) administration and primary care consultation for joint pain, rheumatoid arthritis (RA) flare, corticosteroid prescription, vasculitis and unexplained fever in people with autoimmune rheumatic diseases (AIRDs).

METHODS:
We undertook within-person comparisons using self-controlled case-series methodology. AIRD cases who received the IIV and had an outcome of interest in the same influenza cycle were ascertained in Clinical Practice Research Datalink. The influenza cycle was partitioned into exposure periods (1-14 days prevaccination and 0-14, 15-30, 31-60 and 61-90 days postvaccination), with the remaining time-period classified as non-exposed. Incidence rate ratios (IRR) and 95% CI for different outcomes were calculated.

RESULTS:
Data for 14 928 AIRD cases (69% women, 80% with RA) were included. There was no evidence for association between vaccination and primary care consultation for RA flare, corticosteroid prescription, fever or vasculitis. On the contrary, vaccination associated with reduced primary care consultation for joint pain in the subsequent 90 days (IRR 0.91 (95% CI 0.87 to 0.94)).

CONCLUSION:
This study found no evidence for a significant association between vaccination and primary care consultation for most surrogates of increased disease activity or vaccine adverse-effects in people with AIRDs. It adds to the accumulating evidence to support influenza vaccination in AIRDs.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BMJ at http://dx.doi.org/10.1136/annrheumdis-2019-215086 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: autoimmune diseases, rheumatoid arthritis, vaccination
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
R Medicine > RC Internal medicine > RC927 Rheumatism
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 23 Sep 2019 10:36
Last Modified: 04 Oct 2019 11:26
URI: http://eprints.keele.ac.uk/id/eprint/6865

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