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UT Southwestern rheumatologist recommends patients receive pneumococcal vaccine

New protocol at UTSW empowering nurses to administer vaccines during check-in boosts vaccination rates

A pneumococcal vaccine is recommended for all patients with rheumatic disorders.

DALLAS – Dec. 28, 2022 – Patients with rheumatoid arthritis, lupus, and other rheumatic conditions are more at risk for complications and death from pneumonia, meningitis, and other bacterial infections, yet most have not been vaccinated against infection.

Elena K. Joerns, M.D.

UT Southwestern rheumatologist Elena K. Joerns, M.D., recommends that all patients with rheumatic disorders receive a pneumococcal vaccine to protect against the Streptococcus pneumoniae bacteria, which can cause infections in the ears, sinuses, lungs, spinal fluid, or bloodstream and lead to severe symptoms and hospitalization.

“In people who take immunosuppressant drugs to treat chronic inflammatory conditions, pneumococcal infections are more likely to be severe due to the weakened immune system,” said Dr. Joerns, Instructor in Internal Medicine at UT Southwestern.

According to the Centers for Disease Control and Prevention, just 23.9% of adults ages 64 and younger with a higher risk of infection due to various conditions had received one or more vaccine doses in 2020.

At UT Southwestern, a team in the West Campus Rheumatology-Internal Medicine Subspecialties Clinic has taken steps to boost vaccination rates among its patients, offering greater flexibility to provide vaccines during the check-in process or while patients wait to be seen by a physician.

“These patients often don’t have a lot of time during their clinic visits because they’re dealing with other complex issues, and there is a lack of awareness and knowledge about these vaccines,” Dr. Joerns said.

As a result of the effort, the percentage of unvaccinated patients visiting the clinic decreased from 68.2% in 2019 to 40.5% in 2021, the team reported this month in The Journal of Rheumatology.

The Advisory Committee on Immunization Practices, which provides guidance to the CDC, updated its recommendations in 2022 to give providers and patients the option of a new, single-dose pneumococcal vaccine rather than a three-dose regimen previously recommended, making vaccination more convenient.

Dr. Joerns noted that the new protocol could be useful for administering vaccinations in other clinical settings. “Our data showed that this protocol, which shifts vaccination to be standardized and done as part of patient check-in, allows vaccination to be completed more efficiently and effectively,” she said.

This quality improvement project involving the Clinic was supported by Pfizer Inc. in partnership with the Alliance for Continuing Education.

About UT Southwestern Medical Center

UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.