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 Table of Contents  
EDITORIAL
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 55-56

Addressing the need for pneumococcal and influenza vaccination in chronic obstructive pulmonary disease patients


Department of Pulmonary Medicine, Burdwan Medical College, Burdwan, West Bengal, India

Date of Web Publication23-Jun-2014

Correspondence Address:
Kaushik Saha
Rabindra Pally, 1st Lane, P.O. - Nimta, Kolkata - 700 049, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-8775.135104

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How to cite this article:
Saha K. Addressing the need for pneumococcal and influenza vaccination in chronic obstructive pulmonary disease patients. J Assoc Chest Physicians 2014;2:55-6

How to cite this URL:
Saha K. Addressing the need for pneumococcal and influenza vaccination in chronic obstructive pulmonary disease patients. J Assoc Chest Physicians [serial online] 2014 [cited 2019 Sep 22];2:55-6. Available from: http://www.jacpjournal.org/text.asp?2014/2/2/55/135104


  Introduction Top


Vaccination plays a major role in preventing potentially life-threatening infection in chronic obstructive pulmonary disease (COPD) patients, and thereby decreases the frequency of hospitalization and risk of death. Currently, there is recommendation for use of pneumococcal vaccines (polysaccharide or conjugate) and influenza vaccines (killed or live) in COPD patients. [1]


  Pneumococcal vaccination Top


Beneficial effect of pneumococcal vaccination like significant reduction in hospitalizations and risk of death was shown in a large cohort study in individuals with COPD, whereas another study failed to demonstrate reduction in hospitalizations with the use of pneumococcal vaccination. [2] Currently available pneumococcal vaccines are of two types, polysaccharide vaccines, and conjugate vaccines. [3]

Pneumococcal polysaccharide vaccine (PPSV23) is recommended in COPD patients 65 years and older, and also younger patients with significant comorbid conditions such as cardiac disease except those who are hypersensitive to any component of vaccine. [4] All persons who are aged 65 years and older should receive one dose of PPSV23 and no additional doses of PPSV23 are recommended after this dose. Individuals who had received a dose of PPSV23 before the age 65 years, a minimum interval of 5 years must be there before giving the final dose. [5] This vaccine administration reduces the incidence of community-acquired pneumonia in COPD patients younger than age 65 with an forced expiratory volume in the first second <40% predicted. [6]

Pneumococcal conjugate vaccine (PCV13) has been recently approved in India for prevention of pneumonia in adults (mainly in COPD patients) aged 50 years and older. [3],[5] Immune responses to PCV13 and PPV23 are different and if both vaccines are to be used, PCV13 should be administered first as prior receipt of the PPV23 may result in a blunted response to PCV13. [5],[7] In individuals not received previous doses of PPSV23, give PCV13 first and then give PPSV23 at least 8 weeks later (minimum interval). In individuals received one or more doses of PPSV23, there should be at least 1 year (minimum) interval between the last PPSV23 and the PCV13 dose. [5] Single dose of PCV13 is enough to protect the adult against life-threatening pneumonia for life time.


  Influenza vaccination Top


Influenza vaccination (killed or live) is recommended for all patients with COPD. It can reduce serious illness (such as lower respiratory tract infection requiring hospitalization) and death in COPD patients. [8],[9],[10] It is not recommended for individuals with hypersensitivity to any component of vaccine, especially eggs. The strains are adjusted every year for appropriate effectiveness and should be given once each year before influenza season or at any time throughout season. [11]

 
  References Top

1.Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013;187:347-65.  Back to cited text no. 1
    
2.Niewoehner DE. Clinical practice. Outpatient management of severe COPD. N Engl J Med 2010;362:1407-16.  Back to cited text no. 2
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3.Prevention of pneumonia through vaccination. J Assoc Physicians India 2013;61 Suppl 7:38-40.  Back to cited text no. 3
    
4.Jackson LA, Neuzil KM, Yu O, Benson P, Barlow WE, Adams AL, et al. Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 2003;348:1747-55.  Back to cited text no. 4
    
5.Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2012;61:816-9.  Back to cited text no. 5
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6.Alfageme I, Vazquez R, Reyes N, Muñoz J, Fernández A, Hernandez M, et al. Clinical efficacy of anti-pneumococcal vaccination in patients with COPD. Thorax 2006;61:189-95.  Back to cited text no. 6
    
7.Metersky ML, Dransfield MT, Jackson LA. Determining the optimal pneumococcal vaccination strategy for adults: Is there a role for the pneumococcal conjugate vaccine? Chest 2010;138:486-90.  Back to cited text no. 7
    
8.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: A randomized controlled study. Chest 2004;125:2011-20.  Back to cited text no. 8
    
9.Wongsurakiat P, Lertakyamanee J, Maranetra KN, Jongriratanakul S, Sangkaew S. Economic evaluation of influenza vaccination in Thai chronic obstructive pulmonary disease patients. J Med Assoc Thai 2003;86:497-508.  Back to cited text no. 9
    
10.Fiore AE, Uyeki TM, Broder K, Finelli L, Euler GL, Singleton JA, et al. Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 2010;59:1-62.  Back to cited text no. 10
    
11.Woodhead M, Blasi F, Ewig S, Huchon G, Ieven M, Ortqvist A, et al. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J 2005;26:1138-80.  Back to cited text no. 11
    




 

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