Clinical Data

Clinical and Immunogenicity Data of Pneumococcal Vaccines in Lung Diseases

Evidence indicates that pneumococcal vaccinations in patients with COPD can help prevent CAP and acute exacerbations. Administration of pneumococcal vaccines early in the course of COPD can help in the maintenance of stable health status. However, both vaccination awareness and coverage are poor among these groups of patients.¹

One of the important causes of exacerbations in COPD is S. pneumoniae. A prospective observational study evaluated the impact of PCV13 on the development of exacerbations in patients with COPD. As compared with the non-vaccinated group, the rate of hospitalisation was lower in the vaccinated group (32% vs. 18%). In the non-vaccinated group, the adjusted OR for risk of hospitalisation was 2.77 (P = 0.044). Therefore, the study revealed that in absence of PCV13, the risk of hospitalisation in patients with COPD is almost tripled.²

In the 2017 Cochrane systematic review, 12 randomised controlled trials were reviewed to determine the efficacy of injectable pneumococcal vaccines in patients with COPD. The study involved 2171 patients with COPD, the average age of participants being 66 years. The study revealed that vaccination with PCV13 and PPSV23 significantly lowered the likelihood of COPD exacerbation (OR, 0.60, 95% CI, 0.39-0.93). Some evidence indicated the benefits of pneumococcal vaccination in patients with COPD.³

A review of pneumococcal vaccine efficacy studies reported that the pneumococcal vaccine efficacy in individuals with underlying risk factors, such as COPD or chronic respiratory diseases, varied between −338% and 43%. The overall efficacy observed was 29% (95% CI, −39%-63%) in adults with chronic respiratory diseases, aged ≥50 years.⁴

A study analysed the effectiveness of PCV13 and PPSV23, and long-term formation of adaptive immunity in adult patients with COPD. The clinical effects of vaccination were assessed 1 and 4 years after immunisation. After 4 years, the study group vaccinated with PCV13/PPSV23 demonstrated a 50% decline in the number of patients with COPD exacerbations (P<0.001). At 1 year after vaccination, the vaccinated patients with COPD had elevated levels of IgG antibodies against PCV13 and PPSV23, as compared with the baseline. The study interpreted that initial immunisation with PCV13, followed by a booster dose of PPSV23, should be included in the basic therapy for patients with COPD.⁵

CAP, community-acquired pneumonia; CI, confidence interval; COPD, chronic obstructive pulmonary disease; OR, odds ratio; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal plain polysaccharide vaccine.

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