Résumé
Background: patients under biological therapy for auto-immune diseases are considered immunodepressed and multiple recent recommendations highlight the need for vaccination against influenza and pneumococcal infections.Objectives: to evaluate influenza and pneumococcal vaccine coverage in patients taking biological therapy for Spondyloarthritis (SpA), and to identify factors associated with vaccination completion in this population.Methods: prospective cross-sectional study of a cohort of 500 patients taking biological therapy for Axial Spondyloarthritis. We collected the influenza and pneumococcal vaccine coverage rates, knowledge and opinions about these vaccines according to patients, the place of primary-care physician and rheumatologist in the care and reasons for not proposing the vaccines. SARS-CoV-2 impact and vaccine rates were also assessed.Results: influenza vaccination was received by 46.8% (n=234) of patients. Pneumococcal vaccine had been administered to 61.7% (n=307) of patients. Vaccination coverage against SARS-CoV-2 was high with 91.8% of vaccinated patients. Overall vaccine coverage rates were 34.6% for combination of influenza and pneumococcus and were 33% considering influenza, pneumococcus and SARS-CoV-2. Factors associated with vaccinated status were a higher level of education (OR=1.66 (1.03-2.68), p=0.038) and taking part to educational therapy session (OR=1.85 (1.12-3.06), p= 0.016) for influenza, affiliation to a patients’ association (OR=4.10 (1.10-15.2), p=0.035) and intravenous administration of the bDMARD (OR=3.12 (1.76-5.54), p=0) for pneumococcus. Absences of patient information by the primary-care physician or rheumatologist and concerns about adverse effects were first reported with no vaccination.Conclusion: this study showed insufficient vaccine coverage rates in a population at high risk because of exposure to biological therapy. Reasons for not being vaccinated included fear of adverse effects and lack of information and recommendation. Patient information by healthcare professionals about influenza and pneumococcal vaccination has a major impact and should be reminded as often as possible.