The review presents data on the role of respiratory agents in the pathogenesis of exacerbations of bronchial asthma and the impact of vaccination on the clinical course of the disease. The features of the formation of protective immunity in various immunization schemes are analyzed. In patients with bronchial asthma, the substantiation of the vaccination scheme with the advantage of priority administration of conjugated polysaccharide vaccine followed by the introduction of polysaccharide pneumococcal vaccine after 8 weeks is given. It was shown that vaccination against pneumococcal infection resulted in elimination from sputum S. pneumoniae. Influenza vaccination in patients with bronchial asthma reduced the frequency and duration of exacerbations. Combined vaccination against influenza and pneumococcal infections did not reduce the clinical and immunological effect.

Relevance. Bronchial asthma is widespread in the world, according to WHO estimates, 235 million people suffer from it. In Russia, according to official figures, 1.3 million cases of bronchial asthma have been reported. Domestic experts reasonably believe that these data are underestimated at least 4 times. Considering that patients with bronchial asthma undergo significant changes in the immune system and are especially difficult to tolerate respiratory and other infectious diseases, determining the effect of vaccination on the clinical course of bronchial asthma is very important. The purpose of the review is to show how vaccinations against pneumococcal infection and influenza affect the condition of patients with bronchial asthma. Conclusion. Features of formation of protective immunity at various schemes of immunization against pneumococcal infection are analyzed. In patients with bronchial asthma, the justification of the vaccination scheme with the advantage of the priority administration of conjugated polysaccharide vaccine with the subsequent introduction of a polysaccharide pneumococcal vaccine after 8 weeks is given. Vaccination against pneumococcal infections has led to the elimination of sputum S. рneumoniae. In vaccination against pneumococcal infection, there was an improvement in the level of disease control, which was confirmed by the ACQ-5 test-a decrease in the indicator from 2 [1,5;1,8;3] points (lack of asthma control) to 0,6 [0;1] points (asthma control) during the year of observation, p < 0,001. Vaccination against influenza in patients with bronchial asthma leads to a decrease in the frequency and duration of exacerbations, there is a decrease in the level of markers of systemic inflammation. Combined vaccination against influenza and pneumococcal infection is not accompanied by a reliable difference in tolerability in comparison with monovaccination only against pneumococcal infection or influenza.