Pneumonia is an especially serious problem for people with chronic obstructive pulmonary disease and it’s important to know if vaccination can prevent it. In an updated Cochrane Review from January 2017, Julia Walters from the Cochrane Airways Group in Australia and her colleagues have reviewed the latest evidence and she tells us what they found in this podcast.
John: Hello, I'm John Hilton, editor of the Cochrane Editorial unit. Pneumonia is an especially serious problem for people with chronic obstructive pulmonary disease and it’s important to know if vaccination can prevent it. In an updated Cochrane Review from January 2017, Julia Walters from the Cochrane Airways Group in Australia and her colleagues have reviewed the latest evidence and she tells us what they found in this podcast.
Julia: If someone with chronic obstructive pulmonary disease (known as COPD) develops pneumonia, it’s much more likely to prove fatal than for people without COPD. People with COPD are also at increased risk of pneumonias, either caused by bacteria called Streptococcus pneumoniae or other types of community-acquired pneumonias. They are also subject to acute flare ups or exacerbations. Our review examines the evidence on whether injectable pneumococcal vaccines can prevent pneumonia and these problems.
We identified a total of 12 eligible studies that included nearly 2,200 participants. This is an increase since the evidence was last reviewed in 2010, with the addition of five new studies contributing 600 participants. The average age of participants was 66 years; two thirds were men and they had a diagnosis of moderate to severe COPD. Eleven of the studies compared an injectable vaccine versus a control, and the twelfth compared two different types of injectable vaccine.
We found that people who were vaccinated were less likely to experience an episode of community-acquired pneumonia, such that vaccinating 21 people with COPD would prevent one episode of pneumonia. However, vaccination made no difference to the risk of developing pneumococcal pneumonia due to the Streptococcus pneumoniae bacteria specifically or in the chance of dying or having to be admitted to hospital for a respiratory problem. People who were vaccinated were less likely to experience a COPD exacerbation during their follow up between 6 to 24 months. We found no difference in effectiveness between the two types of injectable vaccine.
In summary, our findings are in line with current Respiratory Guidelines for clinical practice regarding pneumococcal vaccination for people with COPD. The evidence we found in this review suggests that all people with COPD should be given pneumococcal vaccination to provide some protection against community-acquired pneumonia, and to reduce the chance of them having an acute exacerbation of their COPD.
John: If you’d like to find out more about this evidence, the full review provides much more detail and is available online. You can find it by going to Cochrane Library dot com, and running a search for ‘pneumonia vaccines and COPD’.