Influenza Vaccine Coverage Low in RA, But Key in Preventing Severe Disease


Patients with rheumatoid arthritis should be encouraged to receive their yearly flu vaccine.

Although the risk for severe influenza is heightened in patients with chronic diseases like rheumatoid arthritis (RA), rates of annual influenza vaccination remain low in this patient population, according to research results presented at ACR Convergence 2021, the annual meeting of the American College of Rheumatology.1

A group of Canadian researchers presented results from CATCH, the Canadian Early Arthritis Cohort.Adults enrolled in CATCH between 2017 and 2021 who met 2010 American College of Rheumatology/European League Against Rheumatism criteria, had 1+ year of follow-up, and had completed the Beliefs about Medicines Questionnaire were eligible for inclusion. Study investigators sought to evaluate influenza vaccination coverage in the 1 year prior to and 1 year following RA diagnosis, as well as the individual characteristics—including RA medication beliefs—associated with vaccination.

The study cohort included 405 participants (80% White; 67% women; mean age, 56 years) with a symptom duration of 5 months. Prior to diagnosis, 37% of participants reported being vaccinated; this increased to 42% after diagnosis. Among the 233 participants who had vaccination information available after their diagnosis, 68% of those who were vaccinated after their RA diagnosis reported also being vaccinated before diagnosis.

Results of adjusted analyses showed that patients who received pre-diagnosis influenza vaccination were generally aged 65 years or older and had more comorbidities; sex, racial background, education, smoking status, CDAI, or RA medication beliefs at baseline did not impact these rates. Post-diagnosis vaccination was associated with male sex, White race, not smoking, and the use of biologics or Janus kinase inhibitor therapies, as well as pre-diagnosis vaccination.

While certain treatment characteristics—like advanced therapeutics and prior vaccination—are associated with a higher likelihood of vaccination after RA diagnosis, influenza vaccination coverage remains low, the researchers concluded.

“Conversations about beliefs and attitudes about RA medications and vaccination history as part of the diagnostic workup may help increase influenza vaccine coverage,” they added.


  1. Ta V, Schieir O, Valois M-F, et al. Who gets influenza vaccinations prior to and after a diagnosis of RA? Results from the Canadian Early Arthritis Cohort (CATCH). Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 0141.
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