Source of vaccine information and trust in health care professionals influence vaccine hesitancy in rheumatology patients in Italy

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OBJECTIVES: This study aimed to investigate factors related to vaccine hesitancy among patients with autoimmune inflammatory rheumatic diseases (AIIRD) attending two Italian Rheumatology Clinics. METHODS: A survey was distributed to AIIRD patients in two Rheumatology Clinics in Milan and Messina. The survey covered demographic information, medical history, vaccination status, sources of vaccine information and attitudes towards vaccines. A multivariate logistic regression was performed to assess the risk factors associated with not being vaccinated. RESULTS: A total of 371 out of 400 patients responded. Among these, 53.1% reported receiving at least one vaccine among influenza, pneumococcal, meningococcal and zoster, while 18.3% reported no vaccinations and 28.6% were unsure about their vaccination status. Key-factors associated with non-vaccination included reliance on the Internet and social media for vaccine information (p=0.005) and personal knowledge of adverse events (p=0.014). Vaccinated individuals exhibited significantly greater trust in public health agencies (p=0.001), and in vaccine-safety (p=0.004), having an overall more positive attitude towards vaccines (p<0.001). Finally, patients on immunosuppressive therapy were more likely to be vaccinated (OR 2.11, 95% CI 1.05-4.24). CONCLUSIONS: Vaccine hesitancy among AIIRD patients is influenced by several modifiable factors, such as the sources of information they rely on and their level of trust in healthcare professionals. Improving communication between patients and physicians, along with addressing misinformation on digital platforms, could lead to higher vaccine acceptance. Public health initiatives should prioritise targeted interventions that address safety concerns and aim to boost vaccination rates in this high-risk population.

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