Efficacy of Influenza and Pneumococcal Vaccination in Preventing COPD Exacerbation

Abstract

BackgroundCommon causes of exacerbations in chronic obstructive airway disease (COPD) are due to infections by respiratory viruses and bacteria. Influenza vaccine and pneumococcal vaccine have demonstrated decrease in infective exacerbations in this population.MethodsIn this prospective study over 2 years, 146 COPD patients confirmed by spirometry in accordance with GOLD criteria and who received both influenza and pneumococcal polysaccharide vaccine were compared with 146 unvaccinated controls. Number of acute exacerbations, hospitalizations, ICU admissions, need for invasive mechanical ventilation, mortality difference for 1 year following vaccination were compared.ResultsIn vaccinated group there was statistically significant reduction in number of exacerbations of COPD, requirement of hospitalization, ICU admissions and mortality which is depicted in the table. Requirement of mechanical ventilation was higher among cases compared with controls more so among GOLD 3 and 4, which is statistically significant.COPDVaccinatedUnvaccinatedP valueNumber of exacerbations3.234.5<0.001Hospitalization requirement36.3%50%0.018ICU admissions17.8%30.1%0.014Requirement of mechanical ventilation14.2%6.2%0.021Mortality3170.01Subgroup analysis showed a significantly less hospitalization, ICU admission and mortality among vaccinated belonging to GOLD 1 and GOLD 2 as compared with matched controls. Also more exacerbations, hospitalizations, ICU admissions and mortality were observed in GOLD 3 and GOLD 4 who were not vaccinated. But this difference was not statistically significant.ConclusionOverall there was significantly lesser number of exacerbations, hospitalizations, ICU admissions, requirement of mechanical ventilation and mortality among vaccinated group as compared with controls. Subgroup analysis showed a significant benefit from vaccination in COPD GOLD 1 and 2.Disclosures All authors: No reported disclosures.