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- Vaccination coverage according to immunosuppression level among adults with non-rheumatoid arthritis rheumatic diseases: a retrospective observational study in Korea
- Choseok Yoon, Kiho Jeong, Wooyoung Jang, Jinnam Kim, Se Yoon Park, Bongyoung Kim
- Epidemiol Health. 2026;48:e2026018. Published online April 23, 2026
- DOI: https://doi.org/10.4178/epih.e2026018
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Abstract
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AbstractPatients with autoimmune inflammatory rheumatic diseases are particularly vulnerable to infectious diseases. Accordingly, a broader range of vaccines and, in some cases, additional doses are recommended for these patients compared with the general population. This study investigated the vaccination status of adult patients with non-rheumatoid arthritis rheumatic diseases (NRRDs). This retrospective study was conducted in the rheumatology outpatient department of a tertiary care hospital and included adult patients (aged ≥19 years) with NRRDs who received glucocorticoids and/or disease-modifying antirheumatic drugs from January 2023 to March 2023. Among these patients, we compared vaccination rates between high-level immunosuppression (HLI) and non-HLI groups. HLI was defined as current biologic use or prednisolone equivalent at a dose of ≥20 mg/day for ≥14 days. Of the 4,070 patients with NRRDs, 1,522 (37.4%) were in the HLI group. Overall vaccination rates (complete plus partial vaccination) were significantly lower in the HLI group than in the non-HLI group for influenza (20.2 vs. 31.0%, p<0.001), hepatitis B (59.5 vs. 68.8%, p<0.001), pneumococcal disease (12.9 vs. 26.9%, p<0.001), and herpes zoster (4.3 vs. 10.8%, p<0.001). Overall, vaccination rates were low among patients with NRRDs, with especially low rates in the HLI group. These findings highlight the need for systematic vaccination strategies.
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SummaryKorean summary
비류마티스관절염 류마티스 질환(NRRDs)을 가진 대부분의 성인 환자들은 일반 환자들에 비해 감염 위험이 더 높음에도 불구하고 권장되는 성인 예방접종을 완료하지 못한 것으로 확인되었다. 또한 인플루엔자, 폐렴구균, 대상포진 등 주요 백신 예방접종률은 고도 면역억제(high-level immunosuppression, HLI) 군에서 비고도면역억제(non-HLI) 군보다 유의하게 낮았다. 이러한 결과는 비교적 관련 연구가 많이 이루어진 RA 환자군에서뿐만 아니라 NRRDs 가 진단된 국내 면역저하 환자에서 예방의료의 중요한 공백을 보여주며, 이 취약한 집단을 위한 체계적이며 정책이 뒷받침된 예방접종 전략의 필요성을 강조한다.Key Message
Despite being at high risk for infection, most adult patients with non-rheumatoid arthritis rheumatic diseases (NRRDs) did not complete the recommended adult vaccinations. Vaccination rates, including those for the influenza, pneumococcal, and herpes zoster vaccines, were significantly lower in the high-level immunosuppression (HLI) group than in the non-HLI group. Overall, these findings reveal a critical gap in the preventive care of immunocompromised patients with NRRDs and underscore the need for systematic vaccination strategies in this vulnerable population.
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