Deutscher Rheumatologiekongress 2026
Deutscher Rheumatologiekongress 2026
Effectiveness and tolerability of the 2023/2024 influenza vaccine in inflammatory rheumatic disease patients: A nationwide longitudinal self-reported study in Germany
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Introduction: Patients with inflammatory rheumatic disease (IRD) are susceptible to influenza infections and complications yet avoid vaccination for fear of disease exacerbation. Influenza vaccination is an effective and affordable preventive strategy. In Germany, the Standing Committee on Vaccination (STIKO) recommends influenza vaccination for patients with IRD, particularly on immunomodulatory/immunosuppressive therapy. This study evaluates the effectiveness and tolerability of the 2023/24 influenza vaccine in IRD patients using self-reported longitudinal data.
Methods: Patients with IRD were recruited by rheumatology practices, clinics and patient organisations nationwide between October and December 2023 to complete an online survey directly after influenza vaccination and at three and six months thereafter.
Results: A total of 633 patients with IRD participated in the survey; 87.5% were female, with a median age of 50.4 years (range 18–84). The most common conditions were rheumatoid arthritis (50%), connective tissue diseases (28%), and spondyloarthritis (27%). The primary treatments included methotrexate (33%), glucocorticoids (30%), and TNF-alpha inhibitors (24%). Post-vaccination, 50% experienced injection site pain, while 41% reported no side effects. IRD flares occurred in 5.2%, with only 1% requiring adjustment of their antirheumatic therapy. Among 428 patients with follow-up, influenza infections were reported in 38 patients (8.9%), including 10 (2.3%) with reinfections. No severe cases requiring hospitalisation were reported. Spondyloarthritis patients had higher susceptibility to influenza (p=0.002), accounting for 55.3% of infections. IRD flares in the 12 months before vaccination predicted influenza infections despite vaccination (p=0.002).
Conclusion: The influenza vaccine showed high effectiveness and good tolerability in IRD patients during the 2023/2024 season. In influenza-vaccinated IRD patients, no severe cases of influenza infection, defined as the need for hospitalisation were reported. No significant IRD flares were reported due to the vaccination. Given these findings, physicians should recommend vaccination for influenza to IRD patients. The reason for increased risk of influenza infections in patients with spondyloarthritis requires further investigation.



