- Current guidelines recommend influenza and pneumococcal vaccination for COPD patients1,2
- Influenza and pneumonia vaccinations are known to decrease the incidence of lower respiratory tract infections1
- Use key messages to advise your patient on the risks and benefits of vaccination
Consulting the guidelines
- NICE recommend that you offer your COPD patients a pneumococcal vaccination and an annual flu vaccination, to reduce the risk of flu and pneumonia.2
- GOLD recommend offering an influenza vaccine to all COPD patients and provides detailed advice on pneumoccocal vaccination.1
What does the data say?
- Pneumococcal vaccination can reduce patients’ risk of experiencing community-acquired pneumonia vs placebo. Anticipated absolute risk of 94 cases per 1000 patients with vaccine and 143 cases per 1000 patients with placebo control. Odds ratio = 0.62 (95% CI: 0.43 to 0.89). However, no difference was reported for the risk of developing pneumococcal pneumonia. Anticipated absolute risk of 3 cases per 1000 patients with vaccine and 11 cases per 1000 patients with placebo control. Peto odds ratio = 0.26 (95% CI: 0.05 to 1.31). Also, no differences were reported for mortality due to cardiorespiratory diseases, all-cause mortality or hospitalisations, or hospitalisations due to cardiorespiratory causes.3
- Patients receiving pneumococcal vaccination are less likely to experience a COPD exacerbation vs control. Anticipated absolute risk of 482 per 1000 with vaccine and 608 per 1000 with placebo control. Odds ratio = 0.60 (95% CI: 0.39 to 0.93).3
- One randomised controlled trial (RCT) indicated that patients who receive influenza vaccinations have a lower risk of influenza-related acute respiratory illness compared with patients who receive placebo. 4 of 62 vaccinated patients and 17 of 63 unvaccinated patients experienced influenza-related acute respiratory illness, a vaccine effectiveness of 76%.5
Advising your patient
- They are at greater risk of pneumonia compared with people without COPD3
- Pneumococcal vaccination can reduce the risk of developing community-acquired pneumonia3
- Contracting flu may affect the progression of their COPD and frequency of exacerbations4
- There are some mild side effects associated with the flu and pneumococcal vaccines including mild fever, aching muscles, and soreness and redness at the site of injection, but serious side effects are very rare6,7
- Gold Initiative For The Diagnosis, Management, And Prevention of Chronic Obstructive Pulmonary Disease (2019 Report). https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-POCKET-GUIDE-FINAL_WMS.pdf. Accessed January 24, 2019.
- Chronic obstructive pulmonary disease in over 16s: diagnosis and management. December 2018. https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#inhaled-combination-therapy. Accessed January 24, 2019.
- Walters JAE, Tang JNQ, Poole P W-BR. Pneumococcal vaccines for preventing pneumonia in chronic obstructive pulmonary disease (Review) Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 2. 2018;21(1). doi:10.1002/14651858.CD001390.pub4. (https://www.cochranelibrary.com)
- Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;2018(6). doi:10.1002/14651858.CD002733.pub3
- Wongsurakiat P, Maranetra KN, Wasi C, Kositanont U, Dejsomritrutai W, Charoenratanakul S. Acute Respiratory Illness in Patients With COPD and the Effectiveness of Influenza Vaccination. Chest. 2004;125(6):2011-2020. doi:10.1378/chest.125.6.2011
- Suddath C. The Flu Vaccine. NHS. https://www.nhs.uk/conditions/vaccinations/flu-influenza-vaccine/. Published 2008. Accessed March 11, 2019.
- Suddath C. Pneumococcal vaccine - NHS. https://www.nhs.uk/conditions/vaccinations/pneumococcal-vaccination/. Accessed March 11, 2019