Influenza and pneumococcal vaccination in patients with COPD

Abstract

Background: Suboptimal vaccination against influenza and Streptococcus pneumoniae (SP) infections is reported in patients with COPD and could impair outcomes. Understanding underlying factors could help targeting future campaigns.

Objectives: To describe vaccination rates in COPD patients followed by respiratory physicians and analyse associated factors.

Methods: Between 2012 and 2018, 6523 patients were recruited in 3 French COPD cohorts (3067 in COLIBRI, 2653 in PALOMB and 803 in Initiatives BPCO). Data at entry were pooled to describe the population and vaccination rates and perform univariate and multivariate analyses of associated factors.

Results: Population characteristics: female: 34%, mean age: 66 years, current smokers: 35%, mean FEV1: 58% predicted, ≥2 exacerbations in the previous year: 22%, mMRC dyspnea grade ≥2: 59%, cardiovascular comorbidities: 52%, history of asthma: 9%. Vaccinations rates were 34% for flu+SP, 16% for flu alone and 7% for SP alone. In multivariate analyses, flu vaccination was more frequent in older patients, past vs current smokers, patients with comorbidities (cardiovascular, diabetes mellitus, asthma) and mMRC ≥ 1. SP vaccination was associated with hospital-based physicians, past vs current smoking, more exacerbations, presence of chronic bronchitis. FEV1 was not independently associated with vaccination.

Conclusion: Vaccination against influenza and SP infection remains insufficient even in patients followed by respiratory physicians. It appears modulated by specific clinical features while it should be systematic.

Method: COLIBRI: AgiraDOM, AZ, BI, Chiesi, GSK, Novartis; Initiatives BPCO: BI; PALOMB: Fondation Bordeaux Université, Novartis, GSK, Isis, BI; Present analyses: Pfizer.