HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (28) Citing Articles via Google Scholar Google Scholar Articles by Wongsurakiat, P. Articles by Charoenratanakul, S. Search for Related Content PubMed PubMed Citation Articles by Wongsurakiat, P. Articles by Charoenratanakul, S.

Acute Respiratory Illness in Patients With COPD and the Effectiveness of Influenza Vaccination^*

A Randomized Controlled Study

^* From the Division of Respiratory Disease and Tuberculosis, Department of Medicine (Drs. Wongsurakiat, Maranetra, Dejsomritrutai, and Charoenratanakul), and Department of Microbiology (Drs. Wasi and Kositanont), Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Correspondence to: Phunsup Wongsurakiat, MD, Division of Respiratory Disease and Tuberculosis, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; e-mail: sipwo{at}mahidol.ac.th

Study objectives: To determine the effectiveness of influenza vaccination on influenza-related acute respiratory illness (ARI) and overall ARI in patients with COPD, and its relationship to the degree of airflow obstruction.

Design: Stratified, randomized, double-blind, placebo-controlled trial.

Setting: From June 1997 to November 1998 at a single university hospital.

Patients and interventions: One hundred twenty-five patients with COPD were stratified based on their FEV₁ as having mild, moderate, and severe COPD. Within each group, they were randomized to the vaccine group (62 patients who received purified, trivalent, split-virus vaccine) or the placebo group (63 patients).

Measurements: The number of episodes and severity of total ARI, classified as outpatient treatment, hospitalization, and requirement of mechanical ventilation; and the number of episodes and severity of influenza-related ARI.

Results: The incidence of influenza-related ARI was 28.1 per 100 person-years and 6.8 per 100 person-years in the placebo group and vaccine group, respectively (relative risk [RR], 0.24 [p = 0.005]; vaccine effectiveness, 76%). The incidences were 28.2, 23.8, and 31.2 per 100 person-years in the patients with mild, moderate, and severe COPD, respectively, in the placebo group, and 4.5, 13.2, and 4.6 per 100 person-years in the patients with mild, moderate, and severe COPD, respectively, in the vaccine group (RR, 0.16 [p = 0.06]; vaccine effectiveness, 84%; RR, 0.55 [p = 0.5]; vaccine effectiveness, 45%; and RR, 0.15 [p = 0.04]; vaccine effectiveness, 85%, in the patients with mild, moderate, and severe COPD, respectively). Bivariate analysis revealed that the effectiveness of influenza vaccination was not modified by the severity of COPD, comorbid diseases, age, gender, or current smoking status. There was no difference in the incidence or severity of total ARI between the placebo group and the vaccine group.

Conclusions: Influenza vaccination is highly effective in the prevention of influenza-related ARI regardless of the severity of COPD. Influenza vaccination does not prevent other ARIs unrelated to influenza. The effectiveness of influenza vaccination in the prevention of overall ARI in patients with COPD will depend on how much the proportion of influenza-related ARI contributes to the incidence of total ARI. Influenza vaccination should be recommended to all patients with COPD.

Key Words: acute exacerbation • common cold • hospitalization • mechanical ventilation • viral infection

This article has been cited by other articles:

				W. C. Tan and T. P. Ng COPD in Asia: Where East Meets West Chest, February 1, 2008; 133(2): 517 - 527. [Abstract] [Full Text] [PDF]

				M. A. Campos, S. Alazemi, G. Zhang, R. A. Sandhaus, and A. Wanner Influenza Vaccination in Subjects With {alpha}1-Antitrypsin Deficiency Chest, January 1, 2008; 133(1): 49 - 55. [Abstract] [Full Text] [PDF]

				F. W. S. Ko, M. Ip, P. K. S. Chan, M. C. H. Chan, K.-W. To, S. S. S. Ng, S. S. L. Chau, J. W. Tang, and D. S. C. Hui Viral Etiology of Acute Exacerbations of COPD in Hong Kong Chest, September 1, 2007; 132(3): 900 - 908. [Abstract] [Full Text] [PDF]

				G. J. Gorse, T. Z. O'Connor, S. L. Young, M. P. Habib, J. Wittes, K. M. Neuzil, and K. L. Nichol Impact of a Winter Respiratory Virus Season on Patients With COPD and Association With Influenza Vaccination. Chest, October 1, 2006; 130(4): 1109 - 1116. [Abstract] [Full Text] [PDF]

				S. D. Ramsey and F. D. R. Hobbs Chronic Obstructive Pulmonary Disease, Risk Factors, and Outcome Trials: Comparisons with Cardiovascular Disease Proceedings of the ATS, September 1, 2006; 3(7): 635 - 640. [Abstract] [Full Text] [PDF]

				S Scott, P Walker, and P M A Calverley COPD exacerbations {middle dot} 4: Prevention Thorax, May 1, 2006; 61(5): 440 - 447. [Abstract] [Full Text] [PDF]

				S. Sethi and T. F. Murphy RSV Infection -- Not for Kids Only N. Engl. J. Med., April 28, 2005; 352(17): 1810 - 1812. [Full Text] [PDF]

				BMJ, June 26, 2004; 328(7455): 1574 - 1574. [Full Text] [PDF]