title: Effectiveness of a systematic vaccination program in patients with autoimmune inflammatory disease treated with anti-TNF alpha drugs.
abstract: OBJECTIVE
  The objective of this is manuscript is to evaluate the impact of a vaccination protocol in the prevention of infection in autoimmune inflammatory disease (AUTID) patients treated with Anti-TNF-alpha therapies.
  
  
  METHODS
  The authors conducted an observational study to test the effect of a vaccination program in AUTID patients that received anti-TNF-alpha therapies in hospital admissions related to infections. This effect was evaluated by comparing patients admitted before the program started (prevaccination period, 2009-2011) and after the program (postvaccination period, 2011-2014).
  
  
  RESULTS
  The study included 581 patients: 280 in the pre-vaccination group and 301 in the post-vaccination group. During the prevaccination period, 27.3% of patients treated with anti-TNF-alpha drugs were vaccinated before biological therapy. During the postvaccination period, this percentage increased to 97.0%. Statistically significant differences were detected in emergency room visits per 10.000 treatment days, in hospital admissions related to an infectious disease and in the rate of invasive pneumococcal disease due to Streptococcus pneumoniae infection per 10.000 days of treatment.
  
  
  CONCLUSIONS
  This vaccination program decreases infectious complications and was associated with a lower amount of hospital admissions due to infections, emergency room visits and the rate of invasive pneumococcal disease.
authors.affiliation: a Preventive Medicine and Public Health, Preventive Medicine Unit , Hospital de Sagunto , Sagunto , Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fernandez-Martinez
authors.affiliation: b Gastroenterology, Gastroenterology Section, Internal Medicine , Hospital de Sagunto , Sagunto , Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cortes
authors.affiliation: c Hospital Pharmacy, Pharmacy Service , Hospital de Sagunto , Sagunto , Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Borrás-Blasco
authors.affiliation: d Rheumatolgy, Rheumatolgy Service , Hospital de Sagunto , Sagunto , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gracia-Pérez
authors.affiliation: c Hospital Pharmacy, Pharmacy Service , Hospital de Sagunto , Sagunto , Spain.
authors.forename: Md Elvira
authors.initials: ME
authors.lastname: Casterá
keywords: Anti-TNF-alpha therapies; adalimumab; autoimmune inflammatory disease; etanercept; infliximab; vaccine