Publication date: Jul 01, 2025

It has been suggested that vaccinations could induce a trained immunity able to decrease COVID-19 severity. Our primary aim was to evaluate the COVID-19 severity among patients with inflammatory rheumatic diseases (IRD) vaccinated against pneumococcus and influenza compared to those not vaccinated. A secondary objective was also to determine vaccination coverage within real-life population of IRD patients in France. We conducted a longitudinal study within the French administrative and medical data base (SNDS). We have identified patients with one following of these IRD: rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA). COVID-19 infected patients were identified using CIM-10 code and vaccination status was extracted from the database. 406,156 patients were identified, with 64. 6 % women and a mean age of 62. 2 years. Pneumococcal and influenza vaccination rate in this population were respectively 37. 8 % and 40. 5 %. We recorded 0. 9 % COVID-19 hospitalizations (n = 3574), 0. 24 % severe infections (n = 980), and 0. 17 % deaths (n = 697). Multivariate analysis demonstrated pneumococcal vaccination’s association with decreased risks of hospitalization (OR 0. 84 IR95 %[0. 78-0. 91] p

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