tetano
Editor, Senior Moderator
Vaccine
. 2025 Jul 1:61:127439.
doi: 10.1016/j.vaccine.2025.127439. Online ahead of print. Pneumococcal and influenza vaccination coverage and impact on COVID-19 infection severity in patients with inflammatory rheumatic diseases: A French National Healthcare Database analysis
Maxime Auroux[SUP] 1 [/SUP], Thibaut Fabacher[SUP] 2 [/SUP], Erik Sauleau[SUP] 2 [/SUP], Laurent Arnaud[SUP] 3 [/SUP], Fabienne Coury[SUP] 4 [/SUP]
Affiliations
Introduction: It has been suggested that vaccinations could induce a trained immunity able to decrease COVID-19 severity. Our primary aim was to evaluate the COVID-19 severity among patients with inflammatory rheumatic diseases (IRD) vaccinated against pneumococcus and influenza compared to those not vaccinated. A secondary objective was also to determine vaccination coverage within real-life population of IRD patients in France.
Methods: We conducted a longitudinal study within the French administrative and medical data base (SNDS). We have identified patients with one following of these IRD: rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA). COVID-19 infected patients were identified using CIM-10 code and vaccination status was extracted from the database.
Results: 406,156 patients were identified, with 64.6 % women and a mean age of 62.2 years. Pneumococcal and influenza vaccination rate in this population were respectively 37.8 % and 40.5 %. We recorded 0.9 % COVID-19 hospitalizations (n = 3574), 0.24 % severe infections (n = 980), and 0.17 % deaths (n = 697). Multivariate analysis demonstrated pneumococcal vaccination's association with decreased risks of hospitalization (OR 0.84 IR95 %[0.78-0.91] p < 0.0001), severe COVID-19 forms (OR 0.83 IR95 %[0.72-0.96] p < 0.05), and death (OR 0.82 IR95 %[0.70-0.97] p < 0.05), while influenza vaccination associated with increased risks of these outcomes (OR 1.47 IR95 %[1.36-1.58] p < 0.0001, OR 1.54 IR95 %[1.33-1.78] p < 0.0001, OR 1.62 IR95 %[1.36-1.93] p < 0.0001, respectively).
Conclusions: Pneumococcal vaccination was associated with a reduced hospitalization rate, and occurrence of severe forms of COVID-19, including death, among infected patients. These findings suggest the possible involvement of vaccine-induced trained immunity in shaping the immune response to other infections especially COVID-19.
Keywords: COVID-19; Inflammatory rheumatic disease; Influenza vaccination; Pneumococcal vaccination; Trained immunity.
. 2025 Jul 1:61:127439.
doi: 10.1016/j.vaccine.2025.127439. Online ahead of print. Pneumococcal and influenza vaccination coverage and impact on COVID-19 infection severity in patients with inflammatory rheumatic diseases: A French National Healthcare Database analysis
Maxime Auroux[SUP] 1 [/SUP], Thibaut Fabacher[SUP] 2 [/SUP], Erik Sauleau[SUP] 2 [/SUP], Laurent Arnaud[SUP] 3 [/SUP], Fabienne Coury[SUP] 4 [/SUP]
Affiliations
- PMID: 40602345
- DOI: 10.1016/j.vaccine.2025.127439
Introduction: It has been suggested that vaccinations could induce a trained immunity able to decrease COVID-19 severity. Our primary aim was to evaluate the COVID-19 severity among patients with inflammatory rheumatic diseases (IRD) vaccinated against pneumococcus and influenza compared to those not vaccinated. A secondary objective was also to determine vaccination coverage within real-life population of IRD patients in France.
Methods: We conducted a longitudinal study within the French administrative and medical data base (SNDS). We have identified patients with one following of these IRD: rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA). COVID-19 infected patients were identified using CIM-10 code and vaccination status was extracted from the database.
Results: 406,156 patients were identified, with 64.6 % women and a mean age of 62.2 years. Pneumococcal and influenza vaccination rate in this population were respectively 37.8 % and 40.5 %. We recorded 0.9 % COVID-19 hospitalizations (n = 3574), 0.24 % severe infections (n = 980), and 0.17 % deaths (n = 697). Multivariate analysis demonstrated pneumococcal vaccination's association with decreased risks of hospitalization (OR 0.84 IR95 %[0.78-0.91] p < 0.0001), severe COVID-19 forms (OR 0.83 IR95 %[0.72-0.96] p < 0.05), and death (OR 0.82 IR95 %[0.70-0.97] p < 0.05), while influenza vaccination associated with increased risks of these outcomes (OR 1.47 IR95 %[1.36-1.58] p < 0.0001, OR 1.54 IR95 %[1.33-1.78] p < 0.0001, OR 1.62 IR95 %[1.36-1.93] p < 0.0001, respectively).
Conclusions: Pneumococcal vaccination was associated with a reduced hospitalization rate, and occurrence of severe forms of COVID-19, including death, among infected patients. These findings suggest the possible involvement of vaccine-induced trained immunity in shaping the immune response to other infections especially COVID-19.
Keywords: COVID-19; Inflammatory rheumatic disease; Influenza vaccination; Pneumococcal vaccination; Trained immunity.