Systemic sclerosis and vaccinations: a three-year register-based cohort study about vaccination rate and uptake from Liguria referral center, northwest Italy

Figures & data

Table 1. Clinical and demographic characteristics of systemic sclerosis patients

Patient characteristics	Total	Patients vaccinated against flu	Patients not vaccinated against flu	Patients vaccinated against S. pneumoniae	Patients not vaccinated against S. pneumoniae
Number	91	69	22	70	21
Mean age (years)	63.51 (SD 13.98)	66.39 (SD 13.69)	54.45 (SD 10.88)	65.6 (SD 13.46)	56.5 (SD 13.71)
Median age (years)	64 (IQR 54–74.5)	66 (IQR 59–76)	55 (IQR 47.5–59.25)	66 (IQR 57.25–75.75)	57 (IQR 47–66)
Over 65 years old	49.5%	60.6%	18.2%	55.7%	28.6%
Females	82.4%	70.8%	95.2%	80.0%	90.5%
Comorbidities	85.7%	86.9%	81.8%	88.6%	76.2%
Interstitial Lung Disease	61.5%	62.3%	59.1%	64.3%	52.4%
Cardiovascular	53.8%	55.1%	50.0%	55.7%	47.6%
Neoplastic	4.4%	4.3%	4.5%	4.3%	4.8%
Chronic Kidney Disease	18.7%	17.4%	22.7%	18.6%	19.0%
Diabetes	4.4%	5.8%	0.0%	5.7%	0.0%
Smokers	34.1%	33.3%	36.3%	28.6%	52.4%
Ongoing therapy	40.7%	44.9%	27.3%	47.1%	19.0%
Methotrexate	8.8%	10.2%	4.6%	10.0%	4.8%
Mycophenolate mofetil	27.5%	29.0%	18.2%	30.0%	14.3%
Limited cutaneous Systemic sclerosis	50.5%	55.1%	36.4%	54.3%	38.1%
Diffuse Systemic sclerosis	29.7%	26.1%	40.9%	28.6%	33.3%

Table 2. Changes in S. Pneumoniae vaccination coverage between 2017–18, 2018–19 and 2019–2020 seasons

Patient characteristics	2017–2018	2018–2019	2019–2020	p
Total (n)	23.6% (17)	74.7% (68)	76.9% (70)	<.01*
Over 65 years old	24.3%	86.3%	86.7%	<.01*
Males	18.2%	75.0%	87.5%	<.01*
Females	24.6%	82.4%	74.6%	<.01*
Comorbidities	27.8%	78.8%	79.5%	<.01*
Interstitial Lung Disease	30.4%	89.3%	80.4%	<.01*
Cardiovascular	38.5%	85.7%	79.6%	<.01*
Ongoing therapy	35.3%	89.2%	89.2%	<.01*
Methotrexate	40.0%	87.5%	87.5%	.07
Mycophenolate mofetil	26.7%	88.0%	87.5%	<.01*

Statistical significance examined with Fisher’s exact test (the result is significant if p < .05) and the chi-square test, applying the Yates correction when necessary; * statistical significance.

Table 3. Changes in flu vaccination coverage between 2017–18, 2018–19 and 2019–2020 seasons

Patient characteristics	2017–2018	2018–2019	2019–2020	p
Total (n)	58.3% (43)	69.2% (63)	75.5% (69)	<.01*
Over 65 years old	75.7%	88.6%	88.9%	.08
Males	54.6%	75.0%	93.8%	.04*
Females	59.0%	81.0%	72.0%	.12
Comorbidities	60.4%	75.0%	76.9%	.05*
Interstitial Lung Disease	58.7%	77.4%	76.8%	.07
Cardiovascular	76.9%	75.5%	77.6%	.99
Ongoing therapy	34.9%	83.8%	83.8%	<.01*
Methotrexate	60.0%	87.5%	87.5%	.46
Mycophenolate mofetil	73.3%	84.0%	83.3%	.67

Statistical significance examined with Fisher’s exact test (the result is significant if p < .05) and the chi-square test, applying the Yates correction when necessary; * statistical significance.

Table 4. Raw and adjusted odds ratios on each factor evaluated for S. pneumoniae vaccination over the 3-year period

Patient characteristics	Raw OR	Adjusted OR	95% Confidence interval	p
Age over 65 years old	3.15	7.11	1.69–29.88	.01*
Female sex	0.42	0.21	0.03–1.48	.12
Interstitial Lung Disease	1.64	0.79	0.22–2.90	.73
Cardiovascular	1.38	1.32	0.36–4.82	.68
Smoking	0.36	0.70	0.20–2.37	.56
Chronic Kidney Disease	0.97	0.60	0.15–2.50	.49
Immunosuppressive therapy	3.79	3.49	0.76–6.23	.99
Methotrexate	2.22	0.76	0.27–16.12	.99
Mycophenolate mofetil	2.57	1.93	0.69–6.35	.99

Statistical significance examined with Fisher’s exact test (the result is significant if p < .05) and the chi-square test, applying the Yates correction when necessary; * statistical significance.

Table 5. Raw and adjusted odds ratios on each factor evaluated for 2019–2020 seasonal flu vaccination

Patient characteristics	Raw OR	Adjusted OR	95% Confidence interval	p
Age over 65 years old	6.59	43.24	5.93–315.11	>.01*
Female sex	0.17	0.04	0.00–0.63	.02*
Interstitial Lung Disease	1.15	0.34	0.07–1.64	.18
Cardiovascular	1.23	0.70	0.17–2.98	.63
Smoking	0.88	0.78	0.20–3.00	.71
Chronic Kidney Disease	0.72	0.28	0.06–1.24	.09
Immunosuppressive therapy	2.18	3.74	0.16–85.09	.41
Methotrexate	2.37	6.61	0.16–275.16	.32
Mycophenolate mofetil	1.84	5.48	0.21–142.62	.06

Statistical significance examined with Fisher’s exact test (the result is significant if p < .05) and the chi-square test, applying the Yates correction when necessary; * statistical significance.