P2.2 Pneumococcal vaccination

Pneumococcal vaccination is known to be highly effective in preventing invasive bacteraemic pneumococcal pneumonia, but may be less effective in elderly or immunosuppressed patients. (Simberkoff et al., 1986) There is no direct evidence of its efficacy in preventing pneumococcal exacerbations of COPD, (Walters et al., 2011) [evidence level I], but prevention of pneumonia in these patients with already reduced respiratory reserve is a worthy goal in its own right, (Simberkoff et al., 1986, Williams and Moser, 1986, Davis et al., 1987) so pneumococcal vaccination (polyvalent cover­ing 23 virulent serotypes) is recommended in this group [evidence level II].(NHLBI/WHO Workshop Report, April 2001) There is no evidence or rationale for vaccinating more frequently in COPD. Please see the link to The Australian Immunisation Handbook on the NHMRC’s website for further details: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/content/handbook-pneumococcal

The additive effect of pneumococcal vaccination to annual influenza vaccination has been studied in a randomised, controlled trial over two years in Japanese patients with chronic lung disease. (Furumoto et al., 2008) They found a significant additive effect of receiving both vaccines on exacerbations in patients with COPD (influenza vaccine alone = 26% vs. both vaccines =10.3%, p = 0.037), supporting current recommendations for dual vaccination.