Low influenza, pneumococcal and herpes zoster vaccination coverage in Australian patients commencing a biologic or targeted synthetic disease modifying anti-rheumatic drug for inflammatory arthritis: a nationwide cross-sectional data linkage study

Vaccine-preventable infections, such as herpes zoster (HZ), influenza, and pneumococcal disease are major contributors to morbidity and mortality in patients with inflammatory arthritis. To determine national vaccination coverage against influenza, S. pneumoniae and herpes zoster (HZ) in Australian patients dispensed the first script of a b/tsDMARD for inflammatory arthritis (IA). National data was used to determine the number of patients who received vaccination against S. pneumoniae and HZ within 6 months of commencement of the first Pharmaceutical Benefits Scheme (PBS)-subsidised b/tsDMARD for treatment of IA between 1 Feb 2019 and 31 Dec 2021. As the influenza vaccine is funded annually under the National Immunisation Programme, influenza vaccination within 12 months of the first PBS-subsidised b/tsDMARD was determined. Overall, 72.6% (n = 11,225/15,460) of patients underwent influenza vaccination within 12 months of b/tsDMARD initiation. An adjuvanted or high-dose influenza vaccine preparation was used in 27.9% of 60–69 yo, 82.5% of 70–79 yo and 80.3% of ≥ 80 yo. Only 9.7% (n = 1500/15,460) received a pneumococcal vaccine and 2.4% (n = 367/15,460) received HZ vaccination (Zostavax or Shingrix) within 6 months of b/tsDMARD commencement. There was only a small difference in HZ vaccination coverage in those commencing a Janus Kinase inhibitor compared to a bDMARD (3.3% versus 2.1%, respectively, p < 0.001). Vaccination rates in patients initiating a b/tsDMARD for the treatment of inflammatory arthritis in Australia should be improved. This may also apply to patients with IA in other countries.