Influenza vaccine uptake in juvenile idiopathic arthritis during the COVID-19 pandemic: a multi-centre cross-sectional study by PRES vaccination working party.

BACKGROUND: Children with rheumatic diseases are at risk for contracting severe influenza and COVID-19 and are thus targeted for these vaccination. OBJECTIVES: To assess the influenza (flu) vaccination rate in children with Juvenile Idiopathic Arthritis (JIA), investigate families' attitudes towards the influenza vaccine, and the effect of the COVID-19 pandemic on flu vaccine uptake. METHODS: This multi-centre, cross-sectional study was conducted across 9 countries. JIA caregivers completed an anonymous questionnaire about their children's influenza vaccination, including the 2019-2020 and 2020-2021 seasons, including knowledge, and perceptions regarding influenza vaccination. RESULTS: Based on responses from 655 JIA caregivers, 152 children (23.2%) received influenza vaccinations in the 2020-2021 season, representing a significant rise from 18.6% in the previous season (p < 0.01). The likelihood of vaccination was higher among employed/self-employed caregivers compared to unemployed (28.2% and 29.9% vs. 13.9%), and those with tertiary education versus elementary (28% vs. 9.7%), both p < 0.01. Concerns of children's vulnerability to SARS-CoV-2 and severe COVID-19 disease due to JIA were prevalent (51.3% and 85.3% respectively), with 51.3% supporting COVID-19 vaccination. Caregivers who previously vaccinated their children for influenza showed a greater inclination towards SARS-CoV-2 vaccination (73.4% and 79.5%, p < 0.01). CONCLUSIONS: Families of children with JIA reported an increasing flu vaccine uptake and a high intention for COVID-19 vaccine administration. Previous vaccination behavior was shown as a significant predictor of future behaviour. Strengthening health education may address fears and lead to better vaccine coverage against both influenza and SARS-CoV-2 in children with JIA and other inflammatory rheumatic diseases.