Effects of Inactivated Influenza Virus Vaccination on Bronchial Reactivity Symptom Scores and Peak Expiratory Flow Variability in Patients with Asthma

Abstract

Even though annual influenza vaccinations are recommended by many authorities, some doctors may be reluctant to vaccinate asthmatic patients because of the risk of inducing bronchial reactivity and exacerbating the asthma. In this study we investigated the effect of inactivated trivalent influenza vaccine on airway reactivity symptom scores and peak expiratory flow (PEF) variability in 24 patients with mild stable asthma. Baseline spirometry and methacholine challenge tests were performed on all patients. Patients were then asked to record their peak expiratory flow every morning and evening, complete daily symptom score charts (morning tightness, daytime asthma, cough, and night asthma), and note bronchodilator usage for 1 week. After baseline measurements, the patients were allocated to inactivated vaccine and placebo in a random and single-blind manner. The lung function measurements and methacholine challenge tests were repeated 1 week after vaccination and placebo administration at the same time of day. PD20 (mg/mL) methacholine doses were 3.06 ± 3.0 mg/mL before vaccination, 2.96 ± 3.2 mg/mL after vaccination, and 2.76 ± 2.91 mg/mL after placebo administration. There were no significant changes in PD20 methacholine after influenza vaccination (p > 0.05). There were also no significant changes in symptom scores, bronchodilator usage, and PEFR after vaccination (p > 0.05). None of the patients experienced significant local or systemic side effects after vaccination. Immunization with inactivated influenza vaccine does not induce clinical exacerbations of asthma or airway hyperreactivity in patients with mild asthma.