Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;44(6):666-71.
doi: 10.1016/j.semarthrit.2015.01.002. Epub 2015 Jan 22.

Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus

Erica F Lawson  1 , Laura Trupin  2 , Edward H Yelin  2 , Jinoos Yazdany  2
Affiliations

Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus

Erica F Lawson et al. Semin Arthritis Rheum. 2015 Jun.

Abstract

Objective: To better understand why immunosuppressed individuals with systemic lupus erythematosus (SLE) fail to receive influenza and pneumococcal vaccines.

Methods: These cross-sectional data were derived from the 2009 cycle of the Lupus Outcomes Study (LOS), an annual longitudinal telephone survey of individuals with confirmed SLE. Respondents were included in the analysis if they had taken immunosuppressive medications in the past year. We assessed any prior receipt of pneumococcal vaccine and influenza vaccine in the past year, and then elicited reasons for not receiving vaccination. We used bivariate statistics and multivariate logistic regression to assess frequency and predictors of reported reasons for not obtaining influenza or pneumococcal vaccines.

Results: Among 508 respondents who received immunosuppressants, 485 reported whether they had received vaccines. Among the 175 respondents who did not receive an influenza vaccine, the most common reason was lack of doctor recommendation (55%), followed by efficacy or safety concerns (21%), and lack of time (19%). Reasons for not receiving pneumococcal vaccine (N = 159) were similar: lack of recommendation (87%), lack of time (7%), and efficacy or safety concerns (4%). Younger, less-educated, non-white patients with shorter disease duration, as well as those immunosuppressed with steroids alone, were at the greatest risk for not receiving indicated vaccine recommendations.

Conclusions: The most common reason why individuals with SLE did not receive pneumococcal and influenza vaccines was that physicians failed to recommend them. Data suggest that increasing vaccination rates in SLE will require improved process quality at the provider level, as well as addressing patient concerns and barriers.

Keywords: Preventive care; Quality of care; Systemic lupus erythematosus; Vaccine.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Survey questions assessing vaccination status in the 2009 wave of the Lupus Outcomes Study
Figure 2
Figure 2
Study sample from 2009 wave of the Lupus Outcomes Study
Figure 3
Figure 3
Reasons for not receiving influenza and pneumococcal vaccines among immunosuppressed individuals with SLE*
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention Seasonal Infuenza. 2013 [cited; Available from: http://www.cdc.gov/flu/professionals/vaccination/coverage_1112estimates.htm.
    1. Borchers AT, Keen CL, Shoenfeld Y, Gershwin ME. Surviving the butterfly and the wolf: mortality trends in systemic lupus erythematosus. Autoimmunity reviews. 2004;3(6):423–53. - PubMed
    1. Bernatsky S, Boivin JF, Joseph L, Manzi S, Ginzler E, Gladman DD, et al. Mortality in systemic lupus erythematosus. Arthritis Rheum. 2006;54(8):2550–7. - PubMed
    1. Ward MM. Avoidable hospitalizations in patients with systemic lupus erythematosus. Arthritis Rheum. 2008;59(2):162–8. - PubMed
    1. Centers for Disease Control and Prevention Vaccine Recommendation of the Advisory Committee for Immunization Practices. 2013 [cited; Available from: http://www.cdc.gov/vaccines/hcp/acip-recs/index.html.

Publication types

MeSH terms