Nakafero, G, Grainge, MJ, Myles, PR, Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028, Zhang, W, Doherty, M and Nguyen-Van-Tam, JS (2019) Effectiveness of inactivated influenza vaccine in autoimmune rheumatic diseases treated with disease modifying anti-rheumatic drugs. Annals of the Rheumatic Diseases, 78 (8).

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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: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Uncontrolled Keywords: Inactivated influenza vaccine, clinical practice, case studies, autoimmune rheumatic disease flares.
Subjects: Q Science > Q Science (General)
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 06 Feb 2020 14:33
Last Modified: 04 Nov 2020 13:34
URI: https://eprints.keele.ac.uk/id/eprint/7597

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