The effect of smoking on influenza, influenza vaccination efficacy and on the antibody response to influenza vaccination

Abstract

We examined the relation between cigarette smoking and (1) the occurrence of influenza, (2) the efficacy of influenza vaccination and (3) the antibody response to influenza vaccination in fifteen family practices in South-Limburg, the Netherlands, during the influenza season 1991 1992. Data were used from a randomized double-blind placebo-controlled trial into the efficacy of influenza vaccination in which smoking status was measured 10 weeks after the start of the trial. A total of 1838 subjects aged 60 years or older, of whom 1531 subjects (321 smokers, 1152 non-smokers and 58 cigar/pipe smokers) who returned the smoking questionnaire and were not previously vaccinated, were used in the analyses. The main outcome measures were serological influenza (fourfold increase of antibody titre between 3 weeks and 5 months after vaccination); clinical influenza as determined by criteria of the Dutch Sentinel Stations from self reported symptoms in postal questionnaires 10 weeks and 5 months after vaccination; increases after vaccination and decreases after 5 months in logarithmic titres of antibody against the vaccine strains. No relation between smoking and either serological or clinical influenza was found, although the risk for serological influenza was slightly (not significantly) elevated in smokers compared to non-smokers. A statistical interaction was found between smoking and vaccination when serological influenza was the outcome measure indicating that the efficacy of vaccination was greater in smokers than in non-smokers (comparison of model with and without interaction; likelihood ratio test, p < 0.0001). This finding is supported by a greater titre rise 3 weeks after vaccination for two out of four strains, but not by the antibody response after vaccination in previous studies on influenza and other infectious diseases. Also, this possible difference of immunogenicity is not reflected in a better protection for clinical influenza. The rise in antibody titre 3 weeks after vaccination was higher in smokers for A/Singapore/6/86 and B/Beijing/11/87, but not for the other two strains. Decline in titres after 5 months was similar for smokers and non-smokers. We conclude that smoking has no clinical or preventive significance for risk of influenza in the elderly.

Effect of smoking on gastric histology inHelicobacter pylori-positive gastritis

“…Smoking has enhanced the response to influenza vaccines for some, but not all strains [19], while smokers have had reduced IgG but not IgA antibody titres against inhaled pigeon antigens and achieved lower antibody levels after hepatitis B vaccination [20,21]. We found no data on the effect of smoking on humoral response against H. pylori.…”

Cigarette Smoking and Lower Respiratory Tract Infection

“…Influenza rates are similar in vaccinated smokers and nonsmokers. However, influenza vaccination can be considered to be more efficacious in smokers than nonsmokers because the infection rates are higher in unvaccinated smokers (Cruijff et al, 1999). Respiratory syncytial virus bronchiolitis.…”

Is Insomnia a Risk Factor for Decreased Influenza Vaccine Response?

“…The primary hypothesis was that the Insomnia group would have lower levels of influenza antibodies at four weeks postvaccination than the No Insomnia group. Exploratory analyses examined other variables previously linked with reduced influenza vaccine response such as gender (Furman et al, 2014), perceived stress (Kiecolt-Glaser, Glaser, Gravenstein, Malarkey, & Sheridan, 1996; Miller et al, 2004), smoking (Cruijff et al, 1999), and obesity (Sheridan et al, 2012) to determine if they might be significant confounders of the relationship between insomnia and influenza antibody levels.…”