Additive effect of pneumococcal vaccine and influenza vaccine on acute exacerbation in patients with chronic lung disease

Furumoto, Akitsugu; Ohkusa, Yasushi; Chen, Meng; Kawakami, Kenji; Masaki, Hironori; Sueyasu, Yoshiko; Iwanaga, Tomoaki; Aizawa, Hisamichi; Nagatake, Tsuyoshi; Oishi, Kazunori

doi:10.1016/j.vaccine.2008.05.037

Cited by 99 publications

(52 citation statements)

References 34 publications

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“…8 Studies show that 8 -35% of these exacerbations are due to influenza virus 9-12 and 8 -25% are due to pneumococcal infection. 13 The mortality rate of COPD exacerbation after hospitalization is 8%, and patients with frequent exacerbations have a mortality rate of 23%/y. 8 Both influenza and pneumococcal vaccination of patients with COPD seems to be an effective way to prevent some of the bad outcomes of COPD.…”

Section: Discussionmentioning

confidence: 99%

Should Patients With COPD Be Vaccinated?

et al. 2014

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BACKGROUND: Exacerbations of COPD are a major component of the socioeconomic burden related to COPD, and frequent exacerbations are associated with greater decline in health status. Tracheobronchial infections are involved in 50 -70% of exacerbations, so influenza and pneumococcal vaccines are recommended for prevention. The aim of this study was to determine the level of knowledge among COPD patients about the vaccines, find the rate of patients inoculated with both influenza and pneumococcal vaccines, and assess the effectiveness of vaccination status. METHODS: Patients with COPD were recruited from the out-patient clinic of our hospital between September and October 2012. Subject demographic data such as age, gender, level of education, and smoking status were recorded. Vaccination status, number of subjects who were informed by a health-care professional about immunization, and COPD-related emergency or hospital admissions triggered by tracheobronchial infections over 1 y after administration of both influenza and pneumococcal vaccines were noted. RESULTS: Eighty-eight subjects were enrolled during the study period. Eighty-two subjects were male (93.2%), 6 subjects were female (6.8%), and the median age was 61.5 y. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006 classification, 5 subjects were in stage 1 (5.7%), 22 subjects were in stage 2 (25%), 34 subjects were in stage 3 (38.6%), and 27 subjects were in stage 4 (30.7%). Sixty-two subjects had graduated from primary school (70.5%), 21 subjects had graduated from high school (23.9%), one subject had graduated from university (1.1%), and 4 subjects had no education (4.5%). Forty-five subjects (51%) were vaccinated. There was no significant correlation between level of education and vaccination status (P ‫؍‬ .37). Both COPD-related emergency department and hospital visits were significantly decreased in vaccinated patients with COPD (P < .001 and P ‫؍‬ .02, respectively). Of all the subjects, 39.7% (35 of 88 subjects) mentioned that no health-care professional recommended vaccination. CONCLUSIONS: Physicians should be more aware of vaccination and recommend both influenza and pneumococcal vaccines to all patients with COPD to reduce exacerbations.

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Section: Discussionmentioning

confidence: 99%

Should Patients With COPD Be Vaccinated?

et al. 2014

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“…However, a 2008 Cochrane review of adults found a reduction in invasive pulmonary disease after pneumococcal vaccination but no reduction in allcause pneumonia and mortality [34]. Moreover, two studies in Japan showed a reduction in bacterial infections and acute exacerbations of COPD in subjects receiving both influenza and pneumococcal vaccines when compared to either alone [35,36].…”

Section: Pneumococcal Vaccine In Patients With Asthma or Copdmentioning

confidence: 99%

Influenza and pneumococcus vaccination: current recommendations

Ceyhan¹

2016

MMJ

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Acute asthmatic exacerbation and hospital admission may be associated with severe influenza infection. It has been reported that immunization with inactivated influenza vaccine in patients with persistent asthma decreased respiratory illnesses and asthmarelated events. Evidence from more recently published randomized trials indicated that there is no significant increase in asthma exacerbations immediately after influenza vaccination. Similarly, inactivated influenza vaccine in chronic obstructive pulmonary disease (COPD) patients resulted in a significant reduction in the total number of exacerbations when compared with placebo. The highest incidence of invasive pneumococcal disease occurs in children <5 years of age, immunocompromised persons such as HIV, and those ≥65 years of age. Therefore, pneumococcal vaccine has been recommended for all adults ≥65 years of age and in younger patients who have a condition that increases the risk of invasive pneumococcal disease or pneumococcal pneumonia. The development of pneumococcal conjugate vaccines represents a major advance, and the use of such vaccine has reduced the incidence of pneumococcal disease and acute exacerbation in COPD patients. There are limited data about the effect of pneumococcal vaccine on asthmatic patients.

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“…Patients with COPD should receive vaccination against influenza 87-89 (B), which reduces mortality in 41% of cases 89 (B). There is a benefit to the combined use of flu and pneumococcus vaccines with the reduction of hospitalizations, pneumonia and mortality [90][91][92] (B), though the reduction in mortality is influenced more by the protection of the flu vaccine 89.93 (B). The use of PCV7 has led to a reduction in the IPD rate in children under 5 with sickle cell anemia, with a reduction in IPD in 93.4% of cases.…”

Section: (B)mentioning

confidence: 99%

“…There are benefits in using combined vaccines, as immunization with flu and pneumococcus vaccines reduces hospitalizations, respiratory infections and cardiovascular events in patients with heart disease 63 (B); and hospitalizations, pneumonia and mortality in those with CO-PD [90][91][92] (B). The association between vaccines for Haemophius influenzae B and and pneumococcus reduces the cases of IPD by 5% in patients with asplenia or those splenectomized for all reasons 96 (B), with a worse response for those splenectomized due to hematologic malignancies 97 (B).…”

Section: Recommendationmentioning

confidence: 99%