The effect of influenza vaccination on the incidence of chronic obstructive pulmonary disease exacerbations in the immediate postvaccination period

Ting, Simon C H; Crooks, S.; South, Gail

doi:10.1136/jech.2009.092296

Cited by 18 publications

(14 citation statements)

References 8 publications

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“…Two studies assessed the occurrence of COPD exacerbations after influenza vaccination compared to either unvaccinated controls [36], or using a self-controlled method consisting of comparing a pre-defined vaccination period with other time periods in the influenza season for each vaccinated subject [37]. Neither study found evidence of an increased risk of exacerbation up to 14 days post-vaccination (Additional file 2).…”

Section: Resultsmentioning

confidence: 99%

Seasonal influenza vaccination in patients with COPD: a systematic literature review

Bekkat-Berkani¹,

Wilkinson²,

Buchy³

et al. 2017

BMC Pulm Med

106

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BackgroundInfluenza is a frequent cause of exacerbations of chronic obstructive pulmonary disease (COPD). Exacerbations are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression, death, and ultimately, substantial healthcare-related costs. Despite longstanding recommendations to vaccinate vulnerable high-risk groups against seasonal influenza, including patients with COPD, vaccination rates remain sub-optimal in this population.MethodsWe conducted a systematic review to summarise current evidence from randomised controlled trials (RCTs) and observational studies on the immunogenicity, safety, efficacy, and effectiveness of seasonal influenza vaccination in patients with COPD. The selection of relevant articles was based on a three-step selection procedure according to predefined inclusion and exclusion criteria. The search yielded 650 unique hits of which 48 eligible articles were screened in full-text.ResultsSeventeen articles describing 13 different studies were found to be pertinent to this review. Results of four RCTs and one observational study demonstrate that seasonal influenza vaccination is immunogenic in patients with COPD. Two studies assessed the occurrence of COPD exacerbations 14 days after influenza vaccination and found no evidence of an increased risk of exacerbation. Three RCTs showed no significant difference in the occurrence of systemic effects between groups receiving influenza vaccine or placebo. Six out of seven studies on vaccine efficacy or effectiveness indicated long-term benefits of seasonal influenza vaccination, such as reduced number of exacerbations, reduced hospitalisations and outpatient visits, and decreased all-cause and respiratory mortality.ConclusionsAdditional large and well-designed observational studies would contribute to understanding the impact of disease severity and patient characteristics on the response to influenza vaccination. Overall, the evidence supports a positive benefit-risk ratio for seasonal influenza vaccination in patients with COPD, and supports current vaccination recommendations in this population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0420-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Seasonal influenza vaccination in patients with COPD: a systematic literature review

Bekkat-Berkani¹,

Wilkinson²,

Buchy³

et al. 2017

BMC Pulm Med

106

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“…In rare circumstances influenza vaccination has been reported to be associated with eosinophilic pneumonia and respiratory failure [105]. Numerous studies have shown no evidence of increased exacerbation risk [103,106,107] and a systematic review conducted in 2017 reported that influenza vaccination confers a "positive benefit-risk ratio" in the COPD population and that existing data supports annual vaccination in patients with COPD [103].…”

Section: Influenza Infection and Copdmentioning

confidence: 99%

Respiratory viral infection: a potential “missing link” in the pathogenesis of COPD

et al. 2019

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Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of global mortality. Acute exacerbations of COPD frequently necessitate hospital admission to enable more intensive therapy, incurring significant healthcare costs. COPD exacerbations are also associated with accelerated lung function decline and increased risk of mortality. Until recently, bacterial pathogens were believed to be responsible for the majority of disease exacerbations. However, with the advent of cultureindependent molecular diagnostic techniques it is now estimated that viruses are detected during half of all COPD exacerbations and are associated with poorer clinical outcomes. Human rhinovirus, respiratory syncytial virus and influenza are the most commonly detected viruses during exacerbation. The role of persistent viral infection (adenovirus) has also been postulated as a potential pathogenic mechanism in COPD. Viral pathogens may play an important role in driving COPD progression by acting as triggers for exacerbation and subsequent lung function decline whilst the role of chronic viral infection remains a plausible hypothesis that requires further evaluation. There are currently no effective antiviral strategies for patients with COPD. Herein, we focus on the current understanding of the cellular and molecular mechanisms of respiratory viral infection in COPD.

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Section: Introductionmentioning

confidence: 99%

“…Acute respiratory infections constitute a major cause of morbidity and mortality globally [1]. According to the updated 2004 World Health Organization (WHO) report, the death toll from acute lower respiratory infections caused by bacterial and viral infections reached 4.2 million and accounted for 7.2% of all deaths worldwide [1,2]. Data from the Global Burden of Disease study estimated that the mortality rate from lower respiratory tract infections due to influenza reached 0.9 per 100,000 population in the WHO Middle East and North Africa (MENA) region and the hospitalization rate ranged from 100 to 299 per 100,000 population [3].…”

Section: Introductionmentioning

confidence: 99%

“…Given the epidemic nature of the illness, there has been an increasing interest in the burden resulting from its outbreaks in addition to concerns about its association with myocardial infarctions, glycemic variation in diabetic patients, and the exacerbation of other chronic illnesses [1,[18][19][20][21][22][23][24][25][26][27]. While data on the epidemiology and severity of this disease has been primarily obtained from studies in temperate developed countries, developing regions including the MENA region have also begun investigating this burden in their hospitals allowing the formation of more complete global data [28].…”

Section: Introductionmentioning

confidence: 99%

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The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

et al. 2020

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Background: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. Methods: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30th, 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis.

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The effect of influenza vaccination on the incidence of chronic obstructive pulmonary disease exacerbations in the immediate postvaccination period

Abstract: Patients with COPD should be reassured that the influenza vaccination is safe and does not cause an increase in exacerbations. They should be encouraged to take up the vaccination annually before the onset of winter.

Cited by 18 publications

References 8 publications

Seasonal influenza vaccination in patients with COPD: a systematic literature review

Seasonal influenza vaccination in patients with COPD: a systematic literature review

Respiratory viral infection: a potential “missing link” in the pathogenesis of COPD

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

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