IMMUNIZATION OF PATIENTS WITH RHEUMATOID-ARTHRITIS AGAINST INFLUENZA - A STUDY OF VACCINE SAFETY AND IMMUNOGENICITY

Objective. To address the issues of immunogenicity and local and syste mic reactions to vaccination with influenza vaccine in patients with r heumatoid arthritis (RA). Methods. One hundred and twenty-six patients with RA were stratified into 3 groups: (1) those with a history of va ccination with influenza vaccine within 24 months who were receiving u sual therapy for RA, (2) those receiving usual therapy for RA but with out prior vaccine, and (3) those receiving immunosuppressive medicatio n or prednisone greater than or equal to 7.5 mg/day, irrespective of t heir prior immunization status. Within each group, patients were rando mized to receive vaccine or placebo. A group of age matched, healthy c ontrols were also vaccinated. Results. During a one month followup per iod, adverse reactions occurred with equal frequency among patients wi th RA and healthy controls. Similar significant increases in titers to the vaccine were seen in all groups of patients with arthritis and in the controls. Conclusion. The potential increase in susceptibility to influenza and death from respiratory illness in patients with RA and the demonstrated safety and immunogenicity of influenza vaccine should require the inclusion of patients with RA in standard immunization pr ograms.