From the Guidelines
Influenza and COPD Exacerbation
Influenza is strongly associated with chronic obstructive pulmonary disease (COPD) exacerbation.
- The evidence suggests that influenza infection can trigger COPD exacerbations, leading to increased morbidity and mortality in patients with COPD 1.
- Annual influenza vaccination is recommended for patients with COPD to prevent acute exacerbations, as it has been shown to reduce the risk of hospitalization and death from influenza-related complications 1.
- The American College of Chest Physicians and Canadian Thoracic Society guideline recommends administering the influenza vaccine annually to prevent acute exacerbations of COPD, with a Grade 1B recommendation 1.
- While pneumococcal vaccination is also recommended for patients with COPD, the evidence for its role in preventing acute exacerbations is less clear, with a Grade 2C recommendation 1.
- Smoking cessation is also an important component of a comprehensive clinical strategy to prevent acute exacerbations of COPD, as it can improve lung function and reduce symptoms 1.
From the Research
Association between Influenza and COPD Exacerbation
- Influenza is a frequent cause of exacerbations of chronic obstructive pulmonary disease (COPD) 2
- Exacerbations are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression, death, and substantial healthcare-related costs 2
- The evidence supports a positive benefit-risk ratio for seasonal influenza vaccination in patients with COPD, and supports current vaccination recommendations in this population 2
Effectiveness of Influenza Vaccination in Preventing COPD Exacerbation
- Influenza vaccination is effective in preventing hospitalization due to acute exacerbations in COPD patients, with a crude effectiveness of 68.4% and an adjusted effectiveness of 90.8% 3
- Vaccination showed a significant protective effect and reduced the occurrence of exacerbations in the following year, with an odds ratio of 2.11 for influenza vaccination and 1.06 for pneumococcal vaccination 4
- The average effect of current-season influenza vaccination in preventing laboratory-confirmed influenza in COPD patients was 40% 5
Vaccination Coverage and COPD Exacerbation
- Despite longstanding recommendations to vaccinate vulnerable high-risk groups against seasonal influenza, including patients with COPD, vaccination rates remain sub-optimal in this population 2
- The prevalence of influenza vaccination was 23.6% and the pneumococcal vaccination rate was 10.8% among COPD patients 4
- Increasing influenza vaccination coverage can still prevent COPD exacerbations, with an estimated 13.7% of influenza cases in patients with COPD potentially preventable by extending vaccine coverage 5