Factors associated with 2009 monovalent H1N1 vaccine coverage: a cross sectional study of 1,308 patients with psoriasis in France.

Abstract

Patients with immune-mediated inflammatory diseases like psoriasis are at increased risk of infection. Specific recommendations are available regarding vaccinations however the vaccination coverage in patients with chronic inflammatory diseases has received limited attention and studies are not available in patients with psoriasis.
To assess the coverage of 2009 monovalent H1N1 vaccination and to identify factors associated with vaccination among patients with psoriasis.
Patients member of the French psoriasis patients association were sent a self administrated anonymous questionnaire. It consisted in socio-demographic data, history of psoriasis, seasonal and vaccination status. Factors associated with vaccination for A/H1N1 influenza were identified and adjusted odds ratios (ORa) and prevalence ratios (PRa) were estimated with their 95% confidence intervals (95% CIs) using logistic regression models.
1308 psoriasis patients with a mean age of 58.2 years completed the study between September and December 2010. A total of 240 (19%) patients received the 2009 monovalent H1N1 vaccine. 25 out of 75 patients treated with biologics (33%) received the vaccine. Previous influenza seasonal (ORa (PRa)=10.2 (6.6) [6.1 (4.1)-16.9 (10.7)]), pneumococcal (ORa (PRa)=2.0 (1.6) [1.2 (1.1)-3.3 (2.3)]) and hepatitis B (ORa (PRa)=2.2 (1.7) [1.4 (1.1)-3.5 (2.5)]) vaccinations were independently associated with being vaccinated for influenza A(H1N1).
This is the largest study conducted to assess the coverage of 2009 monovalent H1N1 vaccine among patients with psoriasis, a highly prevalent chronic inflammatory disease. This vaccination coverage is more than twice the one in the French general population, but still remained low for patients receiving immunosuppressants. The limited impact of specific recommendations, free vaccines and the massive national campaign warrant alternative strategies in case of future pandemics.