Boesing Maria, Albrich Werner, Bridevaux Pierre-Olivier, Charbonnier Florian, Clarenbach Christian, Fellrath Jean-Marc, Gianella Pietro, Kern Lukas, Latshang Tsogyal, Pavlov Nikolay, Osthoff Michael, Steurer-Stey Claudia, von Garnier Christophe, Leuppi Jörg D
Medicine University Affairs, Cantonal Hospital Baselland, Liestal, Switzerland.
Medical Faculty, University of Basel, Basel, Switzerland.
Praxis (Bern 1994). 2024 Dec;113(11-12):297-305. doi: 10.23785/PRAXIS.2024.11.003.
In Switzerland, additional vaccinations against influenza, COVID-19, Streptococcus pneumoniae and varicella zoster virus (VZV), are recommended for patients with chronic lung diseases such as COPD, asthma or interstitial lung disease, since infectious diseases often lead to exacerbation of lung diseases resulting in increased disease burden and mortality. In this review we give an overview on recommended vaccinations for patients with chronic lung diseases, also including vaccinations against pertussis and RSV, which are recommended in international guidelines. While continuous development of vaccines against S. pneumoniae has given rise to high-valency vaccines covering up to 68% of S. pneumoniae variants in individuals aged ≥65 years, vaccination rates in this age group remain low in Switzerland (10% in 2020). Vaccination rates are higher for influenza, and particularly high-dose vaccines account for high vaccination efficacy in years of low strain matching in individuals at risk. Although mortality of COVID-19 decreased since the emergence of the first SARS-CoV-2 variant, patients with chronic lung disease are still at increased risk for exacerbation, unless vaccinated with variant-adjusted vaccines. VZV and Bordetella pertussis vaccination has also significantly countered reactivation and infection rates, respectively, and subunit vaccines against VZV show long duration. However, pertussis vaccination is still limited by its fast waning. A glimpse into the future presumes the introduction of new higher-valence vaccinations against S. pneumoniae, and several types of RSV vaccines are expected to enter the Swiss market soon.
在瑞士，建议慢性肺病患者（如慢性阻塞性肺疾病、哮喘或间质性肺病患者）接种流感、新冠病毒、肺炎链球菌和水痘带状疱疹病毒（VZV）的额外疫苗，因为传染病常常导致肺病加重，从而增加疾病负担和死亡率。在本综述中，我们概述了慢性肺病患者的推荐疫苗接种情况，还包括国际指南中推荐的百日咳和呼吸道合胞病毒（RSV）疫苗。虽然针对肺炎链球菌的疫苗不断发展，已出现能覆盖≥65岁个体中高达68%的肺炎链球菌变体的高价疫苗，但瑞士该年龄组的疫苗接种率仍然很低（2020年为10%）。流感疫苗接种率较高，特别是高剂量疫苗在毒株匹配度低的年份对高危个体具有较高的疫苗接种效力。尽管自首个严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体出现以来，新冠病毒的死亡率有所下降，但慢性肺病患者仍有更高的病情加重风险，除非接种针对变体调整的疫苗。水痘带状疱疹病毒和百日咳博德特氏菌疫苗接种也分别显著降低了病毒再激活率和感染率，且水痘带状疱疹病毒亚单位疫苗的有效期较长。然而，百日咳疫苗接种仍受其快速衰减的限制。展望未来，预计会引入针对肺炎链球菌的新型更高价疫苗，并且几种呼吸道合胞病毒疫苗有望很快进入瑞士市场。
