International Journal of Research in Medical Sciences | November 2018 | Vol 6 | Issue 11 Page 3698
International Journal of Research in Medical Sciences
Mohanty T et al. Int J Res Med Sci. 2018 Nov;6(11):3698-3704
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Effectiveness of pneumococcal vaccine in patients with chronic
obstructive pulmonary disease (COPD)
Thitta Mohanty, Mahismita Patro, Jyotirmaya Sahoo, Bijaya Kumar Meher*,
Manoranjan Pattnaik, Jeetendra Kumar Patra
INTRODUCTION
COPD is a major cause of respiratory morbidity and
mortality. An exacerbation of COPD is an acute event
characterised by a worsening of the patient’s respiratory
symptoms that is beyond normal day-to-day variations
and leads to a change in medication.
1
There are 3 types of
exacerbations based on ANTHONISEN’S criteria.
Accordingly type 1 exacerbations were defined on the
basis of three major symptoms: increased dyspnoea,
sputum volume and sputum purulence. Type 2
exacerbations required two major symptoms, and type 3
exacerbations required one major symptom plus cough,
wheeze or symptoms of an upper respiratory tract
infection.
2
Department of Pulmonary Medicine, SCB Medical College & Hospital, Cuttack, Odisha, India
Received: 29 August 2018
Accepted: 06 October 2018
*Correspondence:
Dr. Bijaya Kumar Meher,
E-mail: bijoystna@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Pneumococcal infections are frequent cause chronic obstructive pulmonary disease (COPD)
exacerbations and though various guidelines recommend the use of pneumococcal vaccines routinely to COPD
patients to prevent exacerbations, the data regarding the effectiveness of this vaccine is limited and contradictory.
Aims and objectives was to compare the frequency of exacerbations in patients of COPD before and after
administration of pneumococcal vaccine and to find out the frequency of exacerbations in patients of COPD who are
vaccinated against those who are not vaccinated as well as to study the effectiveness of pneumococcal vaccine will be
analysed in respect to age, sex, Body mass index (BMI), severity of disease and other co-morbidity.
Methods: This was a randomized non-placebo controlled trial, conducted from September 2013 to August 2015
including total of 150 patients divided into two groups: cases and controls. The cases were administered PPV23 along
with specific medication and were followed up at intervals of 3months. Exacerbations were identified based on
ANTHONISEN’S criteria. Number of exacerbations in each follow-up was recorded. The data from both the groups
were analysed statistically.
Results: After 1 year of follow up, there was significant reduction in mean number of exacerbations (p value
<0.0001) in patients with COPD in vaccinated group. PPV23 was more effective in patients with COPD of less than
65 years of age and with severe and/or very severe airflow obstruction and also in patients with lower BMI
(≤21kg/m
2
), females and with co-morbidities.
Conclusions: This is an important strategy to prevent the repeated exacerbations in COPD patients particularly in
severe and very severe disease groups and we support the recommendation that pneumococcal vaccine should be
administered to these patients.
Keywords: COPD, Pneumococcal vaccine
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184433