Influenza and pneumococcus vaccination: current recommendations

Abstract

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.