流感和肺炎球菌疫苗对慢性阻塞性肺疾病加重的影响。

Effectiveness of influenza and pneumococcal vaccines on chronic obstructive pulmonary disease exacerbations.

机构信息

National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.

Department of Neurology, Kailuan General Hospital, Tangshan, China.

出版信息

Respirology. 2022 Oct;27(10):844-853. doi: 10.1111/resp.14309. Epub 2022 Jun 15.

DOI:10.1111/resp.14309

PMID:35705329

Abstract

BACKGROUND AND OBJECTIVE

Single-study evidence of separate and combined effectiveness of influenza and pneumococcal vaccination in patients with chronic obstructive pulmonary disease (COPD) is limited. To fill this gap, we studied the effectiveness of trivalent seasonal influenza vaccine (TIV) and 23-valent pneumococcal polysaccharide vaccine (PPSV23), separately and together, at preventing adverse COPD outcomes.

METHODS

Our study used a self-controlled, before-and-after cohort design to assess the effectiveness of TIV and PPSV23 in COPD patients. Patients were recruited from hospitals in Tangshan City, Hebei Province, China. Subjects self-selected into one of the three vaccination schedules: TIV group, PPSV23 group and TIV&PPSV23 group. We used a physician-completed, medical record-verified questionnaire to obtain data on acute exacerbations of COPD (AECOPD), pneumonia and related hospitalization. Vaccine effectiveness was determined by comparing COPD outcomes before and after vaccination, controlling for potential confounding using Cox regression.

RESULTS

We recruited 474 COPD patients, of whom 109 received TIV, 69 received PPSV23 and 296 received TIV and PPSV23. Overall effectiveness for preventing AECOPD, pneumonia and related hospitalization were respectively 70%, 59% and 58% in the TIV group; 54%, 53% and 46% in the PPSV23 group; and 72%, 73% and 69% in the TIV&PPSV23 group. The vaccine effectiveness without COVID-19 non-pharmaceutical intervention period were 84%, 77% and 88% in the TIV group; 63%, 74% and 66% in the PPSV23 group; and 82%, 83% and 91% in the TIV&PPSV23 group.

CONCLUSION

Influenza vaccination and PPSV23 vaccination, separately and together, can effectively reduce the risk of AECOPD, pneumonia and related hospitalization. Effectiveness for preventing AECOPD was the greatest.

摘要

背景与目的

关于流感和肺炎球菌疫苗单独和联合用于慢性阻塞性肺疾病（COPD）患者的有效性的单研究证据有限。为了填补这一空白，我们研究了三价季节性流感疫苗（TIV）和 23 价肺炎球菌多糖疫苗（PPSV23）单独和联合使用预防 COPD 不良结局的有效性。

方法

我们的研究使用自我对照、前后队列设计来评估 TIV 和 PPSV23 在 COPD 患者中的有效性。患者来自中国河北省唐山市的医院。受试者自行选择以下三种接种方案之一：TIV 组、PPSV23 组和 TIV&PPSV23 组。我们使用医生填写、病历验证的问卷获得 COPD 急性加重（AECOPD）、肺炎和相关住院的相关数据。通过比较疫苗接种前后的 COPD 结局，使用 Cox 回归控制潜在混杂因素，确定疫苗的有效性。

结果

我们招募了 474 名 COPD 患者，其中 109 名接受了 TIV，69 名接受了 PPSV23，296 名接受了 TIV 和 PPSV23。TIV 组预防 AECOPD、肺炎和相关住院的总体有效性分别为 70%、59%和 58%；PPSV23 组分别为 54%、53%和 46%；TIV&PPSV23 组分别为 72%、73%和 69%。没有 COVID-19 非药物干预期间的疫苗有效性分别为 TIV 组 84%、77%和 88%；PPSV23 组 63%、74%和 66%；TIV&PPSV23 组 82%、83%和 91%。