INFLUENZA vaccine coverage remains below recommended levels among patients with rheumatic diseases, according to a new systematic review and meta analysis that found substantial gaps in uptake of both influenza and pneumococcal vaccination. The findings suggest that recommended vaccination strategies are not consistently reaching this patient population.
Influenza Vaccine Coverage Remains Below Recommendations
Current clinical guidelines recommend influenza and pneumococcal vaccination for many patients with rheumatic diseases because these individuals are at increased risk of infection. To evaluate how closely these recommendations are being followed, investigators reviewed 51 studies reporting vaccination coverage across several rheumatic conditions.
The pooled influenza vaccination rates were 50% in rheumatoid arthritis, 42% in systemic lupus erythematosus, 43% in spondylarthritis, and 53% in psoriatic arthritis. Pneumococcal vaccination rates were consistently lower, reaching 37%, 30%, 39%, and 41%, respectively. Across all included diseases, vaccine uptake remained below optimal levels despite existing recommendations.
Factors Associated With Vaccination
Among patients with rheumatoid arthritis, those who received vaccination were generally older and had a higher prevalence of comorbidities than those who remained unvaccinated. The analysis also identified geographic location and the use of disease modifying antirheumatic drugs as significant contributors to differences in vaccination coverage reported between studies.
The review also examined factors influencing vaccine uptake. Patients were more likely to receive vaccine education from rheumatologists than from general practitioners, highlighting the important role of specialist care in promoting preventive health measures. At the same time, the most commonly reported reasons for remaining unvaccinated were a lack of awareness about vaccination recommendations and not being offered vaccination by a physician.
Overall, the authors concluded that influenza and pneumococcal vaccination coverage remains suboptimal among patients with rheumatic diseases. They suggest that improving physician led vaccine education, increasing patient awareness, and ensuring vaccination is routinely discussed during clinical care may help improve uptake. The findings also highlight the continued opportunity to strengthen implementation of existing vaccination recommendations across rheumatology practice.
Reference
Du D et al. Vaccination coverage of influenza and pneumococcal vaccines in patients with rheumatic diseases: a systematic review and meta analysis. Rheumatology. 2026. doi:10.1093/rheumatology/keag352.
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