Abstract
Objective: To evaluate vaccination coverage and reasons for non-vaccination in patients with primary Sjögren's syndrome (pSS). Method: A total of 111 patients fulfilling American-European Consensus Group criteria for pSS were interviewed by use of a standardized questionnaire between January 2016 and November 2017 in two French tertiary referral centers for auto-immune diseases. Results: Updated immunization coverage for influenza was 31.5% (n = 35), pneumococcus was 11.7% (n = 13), and diphtheria-tetanus-poliomyelitis (DTP) was 24.3% (n = 27). The main reasons for non-vaccination were fear of side effects from the influenza vaccine (40.3%) and a lack of proposal for the pneumococcal vaccine (72.3%). In vaccinated patients, vaccination was mainly proposed by general practitioners for the influenza vaccine (42.6%) and rheumatologists for the pneumococcal vaccine (41.2%). Probability of influenza vaccination was associated with age (odds ratio/year (OR) 1.04, 95% confidence interval (CI) 1.0-1.1; p = 0.016), history of severe infection (OR 15.9, 95% CI 1.35-186; p = 0.028), low EULAR Sjögren's syndrome disease activity index (OR 0.85, 95% CI 0.75-0.96; p = 0.013), and comorbidities (OR 3.52, 95% CI 1.22-10.2; p = 0.02). Probability of vaccination against pneumococcus was associated with lung comorbidities (OR 3.83, 95% CI 1.11-13.12; p = 0.033) and up-to-date influenza vaccination (OR 3.71, 95% CI 1.08-12.8; p = 0.038). Conclusion: Influenza, pneumococcal, and DTP vaccine coverage was low in patients with pSS included in this study. These results underline the relevance of systematically screening vaccine status in pSS patients and educating patients and physicians on the need for vaccination to improve vaccine coverage in this population.