H1N1 and vaccination of rheumatology patients.

From an Irish perspective we question the transferability of the data reported by Naseem et al to an Irish based Rheumatology population were the H1N1 outbreak was well publicised in 2009/2010 2 . Firstly I would like to highlight that all Rheumatology patient receiving immunosuppressant medications attending our service were actively informed, via postal information, to receive the seasonal and H1N1 vaccine in 2009/2010. The postal information was standardised and provided by the Irish Society for Rheumatology. This was the approach taken by the majority of Rheumatology services in Ireland. In combination with this information patients were advised to contact our nurse-led telephone support service should they have any questions 3 . Unfortunately Naseem S et al do not appear to have taken a similar active approach and therefore we question if higher vaccine uptake levels could be achieved by implying a postal information service. Like Naseem S et al we are currently auditing vaccine uptake among our patients. Initial data, which is still under evaluation, shows a 64% uptake of the H1N1 vaccine, 61% for the influenza vaccine and 9% for the pneumococcal vaccine in 2009.