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

Abstract

BACKGROUND

Influenza vaccination is an important strategy in the prevention of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Despite the proven benefits, there are patients who are reluctant to have this intervention for fear of triggering an exacerbation. There are very few studies looking at the effect of the vaccination on exacerbation rates of COPD in primary care.

METHODS

Medical records were obtained from six primary care practices in the Derbyshire area (UK), and 293 pairs of patients were selected. All patients had a diagnosis of COPD based on post bronchodilator spirometry. Patients were matched according to age, sex, severity of COPD and comorbidities. The first group of patients received the influenza vaccination while the other group served as a control (either never received the vaccination or received it at a later date). The incidence of COPD exacerbations of both groups was recorded.

RESULTS

There were 21 exacerbations in the control group compared to 11 in the vaccinated group. The difference in exacerbation rates between groups was not statistically significant (McNemar's p=0.11). In the 2 weeks after receiving the influenza vaccination, the risk of experiencing an exacerbation in this group of patients was 0.52 in the vaccinated group compared to the non-vaccinated group (OR 0.52, CI 0.29 to 1.14).

CONCLUSION

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.

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  • Authors+Show Affiliations

    ,

    Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, Derbyshire, UK. s.ting@nhs.net

    ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Bronchodilator Agents
    Comorbidity
    Control Groups
    England
    Female
    Forced Expiratory Volume
    Humans
    Incidence
    Influenza Vaccines
    Male
    Medical Records
    Middle Aged
    Pulmonary Disease, Chronic Obstructive
    Registries
    Retrospective Studies
    Severity of Illness Index
    Sex Distribution
    Spirometry
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    19996358

    Citation

    Ting, S C H., et al. "The Effect of Influenza Vaccination On the Incidence of Chronic Obstructive Pulmonary Disease Exacerbations in the Immediate Postvaccination Period." Journal of Epidemiology and Community Health, vol. 65, no. 2, 2011, pp. 157-9.
    Ting SC, Crooks SW, South G. The effect of influenza vaccination on the incidence of chronic obstructive pulmonary disease exacerbations in the immediate postvaccination period. J Epidemiol Community Health. 2011;65(2):157-9.
    Ting, S. C., Crooks, S. W., & South, G. (2011). The effect of influenza vaccination on the incidence of chronic obstructive pulmonary disease exacerbations in the immediate postvaccination period. Journal of Epidemiology and Community Health, 65(2), pp. 157-9. doi:10.1136/jech.2009.092296.
    Ting SC, Crooks SW, South G. The Effect of Influenza Vaccination On the Incidence of Chronic Obstructive Pulmonary Disease Exacerbations in the Immediate Postvaccination Period. J Epidemiol Community Health. 2011;65(2):157-9. PubMed PMID: 19996358.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of influenza vaccination on the incidence of chronic obstructive pulmonary disease exacerbations in the immediate postvaccination period. AU - Ting,S C H, AU - Crooks,S W, AU - South,G, Y1 - 2009/12/08/ PY - 2009/12/10/entrez PY - 2009/12/10/pubmed PY - 2012/5/31/medline SP - 157 EP - 9 JF - Journal of epidemiology and community health JO - J Epidemiol Community Health VL - 65 IS - 2 N2 - BACKGROUND: Influenza vaccination is an important strategy in the prevention of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Despite the proven benefits, there are patients who are reluctant to have this intervention for fear of triggering an exacerbation. There are very few studies looking at the effect of the vaccination on exacerbation rates of COPD in primary care. METHODS: Medical records were obtained from six primary care practices in the Derbyshire area (UK), and 293 pairs of patients were selected. All patients had a diagnosis of COPD based on post bronchodilator spirometry. Patients were matched according to age, sex, severity of COPD and comorbidities. The first group of patients received the influenza vaccination while the other group served as a control (either never received the vaccination or received it at a later date). The incidence of COPD exacerbations of both groups was recorded. RESULTS: There were 21 exacerbations in the control group compared to 11 in the vaccinated group. The difference in exacerbation rates between groups was not statistically significant (McNemar's p=0.11). In the 2 weeks after receiving the influenza vaccination, the risk of experiencing an exacerbation in this group of patients was 0.52 in the vaccinated group compared to the non-vaccinated group (OR 0.52, CI 0.29 to 1.14). CONCLUSION: 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. SN - 1470-2738 UR - https://www.unboundmedicine.com/medline/citation/19996358/The_effect_of_influenza_vaccination_on_the_incidence_of_chronic_obstructive_pulmonary_disease_exacerbations_in_the_immediate_postvaccination_period_ L2 - http://jech.bmj.com/cgi/pmidlookup?view=long&pmid=19996358 DB - PRIME DP - Unbound Medicine ER -