Adherence to Influenza and Meningococcal vaccination in patients with Systemic Lupus Erythematosus referred to the A.O.U. in Pisa and to the Guy’s and St Thomas’ NHS Foundation Trust in London

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory condition that affects millions of people worldwide. Infections have an established role in SLE induction due to molecular mimicry, which leads to immune system activation and auto-antibodies production. Also, infectious episodes are more frequent in SLE patients because of both the underlying disease and the immunosuppressive treatment patients undergo daily. This study aimed either to compare SLE and non-SLE patients’ adherence towards internationally recommended vaccination, namely Influenza and Meningococcal, and to register potential side effects or disease flare reported by patients after immunisation. For this purpose, a questionnaire was read to patients during ward rounds or follow up appointments, and filled up accordingly. Moreover, this study aimed to compare the results of our cohort with those of a cohort of patients with systemic autoimmune diseases (both SLE and non-SLE) at the Guy’s and St. Thomas’ NHS Foundation Trust in London. Among patients in Pisa, results showed that flu vaccine had greater adherence in Non-SLE patients, while Meningococcal vaccine that reached higher percentages in SLE patients. These differences were primarily attributed to variables in age and comorbidities of the two groups. In London, no statistically significant differences were registered between SLE and Non-SLE. Both cohorts of SLE patients were then compared in order to investigate the presence of significant differences in patients’ age, sex, disease duration, treatment in use and adherence towards vaccination. Although differences were to be expected for Meningococcal vaccine, statistically significant differences in flu vaccination were found. Therefore patients in London were asked who had recommended immunisation (GP, Rheumatologist, both or other) and the main reasons not to take the vaccine, when recommended, in order to adopt better strategies to reach optimal coverage levels with vaccines that are generally considered clinically safe