Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, UK
Correspondence to: J. M. Ledingham. E-mail: Jo.Ledingham{at}porthosp.nhs.uk
SIR, We read with interest the letter regarding uptake of influenza vaccination [1]. We undertook a similar survey in our department in 2003 [2].
Sixty patients on immunosuppressive therapy were identified using data collected from the department's annual 4-week survey of out-patient activity. These patients were interviewed by telephone. A further 51 patients on immunosuppressive therapy who attended the day case unit or rheumatology ward during April 2003 were interviewed in person.
Data were collected on whether these 111 patients had received their influenza vaccine during the preceding winter and what sources of information about vaccination they were aware of and had utilized. In addition information regarding pneumovax injections was also collected.
As reported by the Grimsby group [1], the majority of patients (81%) had rheumatoid arthritis; just over a quarter were aged less than 50 yr (27%). Sixty-three per cent of patients were on conventional DMARD therapy and/or corticosteroids; the other 37% were on anti-TNF therapy in addition to DMARDs and/or corticosteroids.
Seventy per cent of patients had received their influenza vaccination. The Government's target for uptake during this period was 70% [3]. Previous departmental surveys of influenza vaccination in 1997 and 2000 showed uptakes of 40% and 56% respectively. There was a clear difference in influenza vaccine uptake according to patient age with the highest uptake in patients over 50 yr of age (83%) compared with only 37% in patients under the age of 50.
The majority of patients (78%) had received information from their GPs; in addition 60% had been aware of information through the media and 64% had received information from the rheumatology department. Six patients sought their vaccinations purely as a result of information provided by the rheumatology department; all six were under the age of 50.
Of the 33 patients who had not received influenza vaccination, 14 would have declined vaccination even if offered and three of these were under the age of 50. All of the remaining 19 patients indicated that they would have accepted vaccination had this been offered; 16 of these were under the age of 50.
Uptake of pneumovax injection within the preceding 10 yr was poor in this patient group (33%). There is currently no Government target for the uptake of pneumovax vaccination and this may well be contributing to the low uptake of this vaccine.
Our results show that, for the local population as a whole, Government targets for influenza vaccination are being met but that there is significant underachievement of these targets in the younger age group. As a result of these findings our department has adopted a policy of more actively targeting influenza vaccine information to this age group and of providing more information with regard to the pneumovax injections to all immunosuppressed patients.
The authors have declared no conflicts of interest.
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