Paediatric and adult bronchiectasis: Vaccination in prevention and management

Abstract

Bronchiectasis has received increased attention recently, including an emphasis on preventing infective exacerbations that are associated with disease progression and lung function decline. While there are several bacteria and viruses associated with bronchiectasis, licensed vaccines are only currently available for Streptococcus pneumoniae, Haemophilus influenzae (H. influenzae protein D as a conjugate in a pneumococcal vaccine), Mycobacterium tuberculosis, Bordetella pertussis and influenza virus. The evidence for the efficacy and effectiveness of these vaccines in both preventing and managing bronchiectasis in children and adults is limited with the focus of most research being on other chronic lung disorders, such as chronic obstructive pulmonary diseases, asthma and cystic fibrosis. We review the existing evidence for these vaccines in bronchiectasis and highlight the existing gaps in knowledge. High-quality experimental and non-experimental studies using current state-of-the-art microbiological methods and validated, standardised case definitions are needed across the depth and breadth of the vaccine development pathway.

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

“…Vaccination is an important consideration in the preventative care of children and adults with bronchiectasis. Expert opinion recommends giving the seasonal influenza vaccination, as well as ensuring maintenance of vaccination against S. pneumonia, H. influenzae, and Bordetella pertussis when appropriate for the patient and not otherwise contraindicated (94)(95)(96)(97). Most patients with antibody deficiencies are maintained on IgRT and are receiving antibody protection passively.…”

Exacerbations of bronchiectasis

“…The effect of vaccines on bronchiectasis exacerbations has not been extensively studied but the limited available evidence suggests benefit [ 121 , 122 ]. Given the robust evidence for vaccination in other respiratory diseases and the high risk of exacerbations in bronchiectasis, influenza and pneumococcal vaccines are recommended [ 36 , 65 , 92 ].…”

Contemporary Concise Review 2018: Bronchiectasis

“…This means bronchiectasis patients must avoid direct contact with CF patients, including not sharing outpatient waiting rooms, clinic rooms or hospital bays . Otherwise, until further evidence for cross‐infection emerges, standard infection control measures are recommended, that comprise strict hand and cough hygiene, updated vaccinations and avoiding other patients when unwell or during an exacerbation.…”