{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:08:42Z","timestamp":1778821722208,"version":"3.51.4"},"reference-count":53,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Introduction: Patients with inflammatory arthritis are at increased risk of infection due to immune dysregulation and immunosuppressive therapy. National and international guidelines recommend vaccination against pneumococcal disease, influenza, COVID-19, and herpes zoster; however, uptake remains inconsistent. This study evaluated op-world uptake of multiple recommended vaccines within a large UK cohort. Methods: We conducted a cross-sectional study of adults with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis across three hospital sites serving ~800,000 people. Eligible patients had a healthcare encounter within 12 months prior to 1 January 2026. Vaccination status (pneumococcal, influenza, COVID-19, shingles) was obtained from linked primary care records. Demographic and clinical variables were collected. Uptake was reported as percentages with 95% confidence intervals. Associations with pneumococcal vaccination were assessed using Poisson regression with robust standard errors. Results: Among 2158 patients (median age 58 years; 72% female), rheumatoid arthritis was most common (61%). Most were receiving biologic or targeted synthetic DMARDs. Vaccine availability was not limited. Uptake was suboptimal: pneumococcal 30%, influenza 29%, COVID-19 53%, and shingles 12%. Pneumococcal uptake was higher in those aged \u226565 years. Increasing age (aRR 1.92, 95% CI 1.52\u20132.42) and at-risk comorbidities (aRR 1.42, 95% CI 1.20\u20131.69) were associated with higher uptake, while biologic or targeted therapy was associated with lower uptake (aRR 0.55, 95% CI 0.48\u20130.63). Discussion: Vaccination uptake remains suboptimal in this high-risk population. Lower uptake in patients on advanced therapies highlights a gap in care. Targeted education and better integration of vaccination pathways within rheumatology services are needed.<\/jats:p>","DOI":"10.3390\/vaccines14050400","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:03:47Z","timestamp":1777536227000},"page":"400","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uptake of Shingles, Influenza, COVID-19 and Pneumococcal Vaccination in Patients with Inflammatory Arthritis: A Three-Centre Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9377-6618","authenticated-orcid":false,"given":"Krishika","family":"Balakrishnan","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lozan Hussein Mahmood","family":"Zangana","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moyinoluwa Rachel","family":"Ajayi","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8074-4932","authenticated-orcid":false,"given":"Marcin","family":"Kowalczyk","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1307-6528","authenticated-orcid":false,"given":"Deepak","family":"Nagra","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Disease, King\u2019s College London, London WC2R 2LS, UK"},{"name":"University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Li","family":"Goh","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariam","family":"Baghaffar","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madusha","family":"Jayesinghe","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rofaida","family":"Hassan","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad","family":"Khan","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Gayed","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Godlee","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Khan","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujata","family":"Ganguly","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvind","family":"Sinha","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Stathopoulou","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Trust, Solihull, Heartlands & Good Hope Hospital, Birmingham B75 7RR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Adas","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Disease, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zijing","family":"Yang","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Disease, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Galloway","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Disease, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e000935","DOI":"10.1136\/rmdopen-2019-000935","article-title":"Serious infection risk in rheumatoid arthritis compared with non-inflammatory rheumatic and 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