Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD

Abstract

Background: Influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary disease (COPD). A recent study from Tayside found a reduced risk of all-cause mortality with vaccination in patients with COPD. The Health Improvement Network (THIN) database was used to test this hypothesis in a different data source. Methods: The THIN database was searched for patients with COPD. Vaccination status against Pneumococcus and the annual influenza vaccination status were determined. Mortality rates were calculated in the periods December to March and April to November. Relative risks for the effect of vaccination on all-cause mortality were estimated by Poisson regression, adjusting for age, sex, year and serious co-morbidities. Results: 177 120 patients with COPD (mean age 65 years) were identified, with a mean follow-up of 6.8 years between 1988 and 2006. Vaccination rates against influenza rose from ,30% before 1995 to .70% in 2005 in patients aged 60 years or more. The cumulative vaccination rate against pneumonia rose from almost zero to 70% in patients aged 70 years or more over the same period. For all-cause mortality the adjusted relative risks associated with influenza vaccination were 0.59 (95% CI 0.57 to 0.61) during the influenza season and 0.97 (95% CI 0.94 to 1.00) outside the season in patients not vaccinated against pneumonia, and 0.30 (95% CI 0.28 to 0.32) and 0.98 (95% CI 0.96 to 1.11), respectively, in patients vaccinated against pneumonia. The relative risk associated with pneumococcal vaccination was .1 at all times of the year. Conclusions: Influenza but not pneumococcal vaccination was associated with a reduced risk of all-cause mortality in COPD.Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide resulting in more than 2.7 million deaths in 2000.1 COPD exacerbations are a common cause of mortality and morbidity and prevention is an important strategy as effective treatment of exacerbations is still inadequate. Vaccinations against influenza and pneumococcus are recommended in NICE guidelines for COPD.

Multiple Myeloma Vaccination Patterns in a Large Health System: A Pilot Study

“…For example, rates of FV in patients over 60 years old went from <30% in 1995 to >70% in 2005, which resulted in a decrease in all-cause mortality. 25 An even greater increase in PV rate (from 0 to >70%) occurred over the same period of time; however, there was no discernible benefit for its use. Another study found that FV reduced exacerbations in chronic obstructive pulmonary disease, showing that the vaccine can influence patient care.…”

The Frequency of Influenza and Pneumococcal Vaccination in COPD

“…6,17,18 Diğer yandan, pnömokok aşısının KOAH'lı hastalarda pnömo-kokal pnömoni riskini azalttığı gösterilse de mortaliteyi etkilemediği belirlenmiştir. 19,20 Ancak pnömokok aşılama-sından sonra IgG ve IgG2 düzeylerinin anlamlı derecede yükselmesi, aşının koruyucu özelliğini kanıtlamaktadır. 21 Sonuçta KOAH olgularında aşı uygulamasının mortalite ve morbiditenin azaltılmasında etkin bir yaklaşım olduğu görülmektedir.…”

Zalecenia Polskiego Towarzystwa Chorób Płuc Dotyczące Rozpoznawania i Leczenia Przewlekłej Obturacyjnej Choroby Płuc

“…Skład szczepów w szczepionce jest każdego roku dobiera ny w ten sposób, aby uodparniać przeciw szczepowi spodziewanemu w następnym sezonie. Szczepienia przeciw grypie zmniejszają częstość zaostrzeń, hospitalizacji oraz śmiertelność u chorych na POChP [65].…”