Objectives. To examine temporal trend in uptake of seasonal influenza vaccine (SIV) in the UK and explore disease and demographic factors associated with vaccination. Methods. From the Clinical Practice Research Datalink, 32 751 people with auto-immune rheumatic diseases prescribed DMARDs between 2006 and 2016 were identified. The proportion vaccinated between 1 September of one year and 31 March of the next year was calculated and stratified by age, other indications for vaccination,

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... e rheumatic diseases type and number of DMARDs prescribed. Stata and Joinpoint regression programs were used. Results. SIV uptake was high in those aged 565 years (82.3 and 80.7% in 200607 and 201516, respectively). It was significantly lower in other age groups, but improved over time with 51.9 and 61.9% in the 4564 year age group, and 32.3 and 50.1% in the <45 year age group being vaccinated in 200607 and 201516, respectively. While 64.9% of the vaccinations in those 565 years old occurred by 3 November, in time to mount a protective immune response before the influenza activity becomes substantial in the UK, only 38.9% in the 4564 year and 26.2% in the <45 year age group without any other reason for vaccination received SIV by this date. Women, those with additional indications for vaccination, on multiple DMARDs and with SLE were more likely to be vaccinated. Conclusion. SIV uptake is low in the under 65s, and the majority of them are not vaccinated in time. Additional effort is required to promote timely uptake of SIV in this population.