Annual flu vaccinations are highly effective at preventing acute respiratory illness and
making sure that existing breathing problems don't get any worse, according to
research published in the April issue of IJCP, the UK-based International Journal of
Clinical Practice.
A study of 87 patients with chronic obstructive pulmonary disease (COPD) - a major
cause of ill health and death - found that having the annual flu vaccine reduced
overall problems by more than two-thirds.
The vaccinations were particularly effective at providing protection for patients with
severe COPD, where the incidence of additional respiratory problems fell by threequarters.
"COPD is a serious lung disease that causes breathing problems and is responsible
for a significant number of outpatient and emergency department visits as well as
inpatient hospital stays" says lead author Dr Balakrishnan Menon from the
Vallabhbhai Patel Chest Institute at the University of Delhi, India.
"It has increased by 40 per cent since 1942 and is now the world's fourth leading
cause of death and twelfth leading cause of disability. The World Health Organization
(WHO) predicts that by 2020 it will become the third leading cause of death and rise
significantly in the disability stakes to fifth place.
"Most of the healthcare costs associated with COPD are due to problems that worsen
the condition and infections caused by the influenza virus are major culprits.
"Despite the WHO's recommendation that all patients with COPD should receive the
annual flu vaccine, the injection is not used as widely as it could be, especially in
developing countries.
"Our research suggests that this could be leading to higher levels of respiratory
problems and that these extra healthcare costs could be avoided by improving the
uptake of this simple preventative measure."
The 87 male patients, who had an average age of just under 65, were monitored for
a year before and after they received the vaccine. All had been diagnosed with
COPD, but none of them had previously received the flu vaccine.
After the patients received the vaccine, the overall incidence of acute respiratory
illness and acute exacerbation of COPD fell by 67 per cent, with 24 patients
experiencing them before they received the vaccinee and eight experiencing them in
the post-vaccination period.
The effectiveness of the vaccine varied, depending on how badly people suffered
from the disease. People with mild or moderate COPD saw a 60 per cent reduction in
overall incidence and people with severe COPD enjoyed a 75 per cent reduction.
Outpatient visits fell by 50 per cent after vaccination and there was also a 70 per cent
reduction in the number of study participants who were hospitalised.
During the two-year study period patients attended monthly check-ups and received
the same level of medication, healthcare and lifestyle advice. Any respiratory
problems were also carefully monitored.
The researchers were careful to ensure that no other factors clouded the results so
that they could observe the effect of the influenza virus more efficiently. This included
having an all male study group. Fewer women met the study criteria, mainly because
they were less likely to smoke ��" 83 per cent of the men in this study were current or
former smokers.
"Influenza viruses are a major cause of death and serious illness in elderly people,
particularly if they suffer from COPD" concludes Dr Menon.
"Our study was undertaken in a population where uptake of the vaccine is
traditionally low and it had a marked effect on the men who received it. This could
also explain why our 67 per cent reduction was higher than the 32 to 45 per cent falls
reported by previous studies carried out in populations where the vaccine is more
common.
"We believe that our research underlines the importance of increasing vaccine use
worldwide, especially in patients with COPD and in areas where the flu vaccination
rate is low.
"It is clear that annual flu vaccinations have a major role to play in bringing down the
number of preventable deaths and hospital admissions that occur every year in
patients with chronic lung diseases."
"Comparison of outpatient visits and hospitalisations in patients with chronic obstructive
pulmonary disease, before and after influenza vaccination". Menon et al. IJCP, the
International Journal of Clinical Practice. 62.4, pp 593-598.
IJCP, the International Journal of Clinical Practice was established in 1946 and is edited
by Dr Graham Jackson from Guy's and St Thomas' NHS Foundation Trust, London, UK.
It provides its global audience of clinicians with high-calibre clinical papers, including
original data from clinical investigations, evidence-based analysis and discussions on the
latest clinical topics. The journal is published by Blackwell Publishing Ltd, part of the
international Blackwell Publishing group. blackwellpublishing/ijcp
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