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Ann Rheum Dis. 2019 Apr 29. pii: annrheumdis-2019-215086. doi: 10.1136/annrheumdis-2019-215086. [Epub ahead of print]
[h=1]Association between inactivated influenza vaccine and primary care consultations for autoimmune rheumatic disease flares: a self-controlled case series study using data from the Clinical Practice Research Datalink.[/h] Nakafero G[SUP]1[/SUP], Grainge MJ[SUP]2[/SUP], Myles PR[SUP]2[/SUP], Mallen CD[SUP]3[/SUP], Zhang W[SUP]4[/SUP], Doherty M[SUP]4[/SUP], Nguyen-Van-Tam JS[SUP]2[/SUP], Abhishek A[SUP]4,[/SUP][SUP]5[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] ObjectivesTo examine the association between inactivated influenza vaccine (IIV) administration and primary care consultation for joint pain, rheumatoid arthritis (RA) flare, corticosteroid prescription, vasculitis and unexplained fever in people with autoimmune rheumatic diseases (AIRDs).
[h=4]METHODS:[/h] We undertook within-person comparisons using self-controlled case-series methodology. AIRD cases who received the IIV and had an outcome of interest in the same influenza cycle were ascertained in Clinical Practice Research Datalink. The influenza cycle was partitioned into exposure periods (1-14 days prevaccination and 0-14, 15-30, 31-60 and 61-90 days postvaccination), with the remaining time-period classified as non-exposed. Incidence rate ratios (IRR) and 95% CI for different outcomes were calculated.
[h=4]RESULTS:[/h] Data for 14 928 AIRD cases (69% women, 80% with RA) were included. There was no evidence for association between vaccination and primary care consultation for RA flare, corticosteroid prescription, fever or vasculitis. On the contrary, vaccination associated with reduced primary care consultation for joint pain in the subsequent 90 days (IRR 0.91 (95% CI 0.87 to 0.94)).
[h=4]CONCLUSION:[/h] This study found no evidence for a significant association between vaccination and primary care consultation for most surrogates of increased disease activity or vaccine adverse-effects in people with AIRDs. It adds to the accumulating evidence to support influenza vaccination in AIRDs.
? Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
[h=4]KEYWORDS:[/h] autoimmune diseases; rheumatoid arthritis; vaccination
PMID: 31036623 DOI: 10.1136/annrheumdis-2019-215086
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[h=1]Association between inactivated influenza vaccine and primary care consultations for autoimmune rheumatic disease flares: a self-controlled case series study using data from the Clinical Practice Research Datalink.[/h] Nakafero G[SUP]1[/SUP], Grainge MJ[SUP]2[/SUP], Myles PR[SUP]2[/SUP], Mallen CD[SUP]3[/SUP], Zhang W[SUP]4[/SUP], Doherty M[SUP]4[/SUP], Nguyen-Van-Tam JS[SUP]2[/SUP], Abhishek A[SUP]4,[/SUP][SUP]5[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] ObjectivesTo examine the association between inactivated influenza vaccine (IIV) administration and primary care consultation for joint pain, rheumatoid arthritis (RA) flare, corticosteroid prescription, vasculitis and unexplained fever in people with autoimmune rheumatic diseases (AIRDs).
[h=4]METHODS:[/h] We undertook within-person comparisons using self-controlled case-series methodology. AIRD cases who received the IIV and had an outcome of interest in the same influenza cycle were ascertained in Clinical Practice Research Datalink. The influenza cycle was partitioned into exposure periods (1-14 days prevaccination and 0-14, 15-30, 31-60 and 61-90 days postvaccination), with the remaining time-period classified as non-exposed. Incidence rate ratios (IRR) and 95% CI for different outcomes were calculated.
[h=4]RESULTS:[/h] Data for 14 928 AIRD cases (69% women, 80% with RA) were included. There was no evidence for association between vaccination and primary care consultation for RA flare, corticosteroid prescription, fever or vasculitis. On the contrary, vaccination associated with reduced primary care consultation for joint pain in the subsequent 90 days (IRR 0.91 (95% CI 0.87 to 0.94)).
[h=4]CONCLUSION:[/h] This study found no evidence for a significant association between vaccination and primary care consultation for most surrogates of increased disease activity or vaccine adverse-effects in people with AIRDs. It adds to the accumulating evidence to support influenza vaccination in AIRDs.
? Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
[h=4]KEYWORDS:[/h] autoimmune diseases; rheumatoid arthritis; vaccination
PMID: 31036623 DOI: 10.1136/annrheumdis-2019-215086
Free full text