Influenza Vaccination in Adults with Asthma: Safety of an Inactivated Trivalent Influenza Vaccine

Abstract

Despite recommendations in most countries for giving inactivated influenza vaccine to people with asthma, only a minority currently receive it. One reason for low vaccine coverage has been concern that vaccination may induce exacerbations of asthma. In this randomized trial, 291 patients between 18 and 65 years of age received either an inactivated influenza vaccine followed 14 days later by a saline placebo or placebo followed by the vaccine. Each patient received 1 dose of vaccine and 1 dose of placebo. The percentage of patients reporting at least one asthma exacerbation within 14 days after injection was similar following vaccine or placebo (28.3% and 25.5%, respectively). The combined exacerbation rate during the first 14-day interval was higher (31.5%) than that during the second 14-day interval (22.4%, P = 0.0135), indicating that the occurrence of exacerbations was not likely to be related to the sequence of injections. The percentages of individuals with solicited systemic symptoms were 56.6% and 44.8% after vaccine or placebo injection, respectively. We conclude that influenza vaccination did not increase the incidence of asthma exacerbations compared to placebo in this study and the vaccine was well tolerated. The results thus support annual influenza vaccination in patients with asthma.

Prevention and Control of Seasonal Influenza with Vaccines

“…A randomized study of IIV3 versus placebo among 262 asthmatic adults noted that vaccination was associated with a decline in peak expiratory flow; however, this effect was no longer significant when adjusted for the presence of concomitant symptomatic cold symptoms (375). A randomized crossover design study of IIV3 versus saline placebo showed no significant difference in the occurrence of asthma exacerbations during the 14 days postvaccination (376).…”

Influenza vaccination in patients with pulmonary sarcoidosis: efficacy and safety

“…High antibody titers against several antigens (Epstein–Barr, herpes simplex, rubella, measles and parainfluenza viruses, and mismatched blood) have been detected in patients with sarcoidosis 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 . In contrast, in the study of Mert et al.…”

“…High antibody titers against several antigens (Epstein-Barr, herpes simplex, rubella, measles and parainfluenza viruses, and mismatched blood) have been detected in patients with sarcoidosis. 5,[8][9][10][11][12][13][14][15][16][17][18] In contrast, in the study of Mert et al, 16 none of 16 patients with sarcoidosis developed antibody response to hepatitis B vaccine. In another study, peripheral blood B cells obtained from patients with sarcoidosis produced less immunoglobulin against pokeweed-mitogen compared to normal B cells.…”

“…Although, to our knowledge, antibody response against influenza vaccine in patients with sarcoidosis is not yet investigated, this vaccine is highly recommended in patients with chronic pulmonary diseases such as asthma, chronic obstructive pulmonary disease, and fibrosis 17 , 18 , 19 , 20 , 21 . In this case–controlled clinical trial, we aimed to evaluate the humoral response to the trivalent 2008–2009 influenza vaccine in patients with sarcoidosis and assess vaccine safety.…”

Hintergrundpapier der STIKO: Evaluation der bestehenden Influenzaimpfempfehlung für Indikationsgruppen und für Senioren (Standardimpfung ab 60 Jahren)

“…RCTs, in denen mono-oder bivalente Impfstoffe verwendet (n = 2), verschiedene Influenzaimpfstoffe miteinander verglichen (n = 3), ein atypisches Impfschema angewendet (n = 1) oder in denen Lebendimpfstoffe eingesetzt wurden (n = 3), gingen in die vorliegende Analyse nicht ein. Von den verbleibenden 9 RCTs machten 4 Studien Angaben zu den folgenden von der STIKO a priori festgelegten patientenrelevanten Endpunkten [51,[64][65][66][67] …”