Influenza vaccine and acute exacerbationsof Chronic Obstructive Pulmonary Disease: a cross-sectional study

Abstract

Background: Influenza (flu) is one of the most frequent infections associated with acute exacerbations of Chronic Obstructive
Pulmonary Disease (COPD). Objective: To determine the association between flu vaccine use and acute exacerbation of
COPD and the cost of COPD exacerbations. Methods: Cross-sectional, multicenter study at two hospitals and three clinics in
Lima and Callao, Peru. All subjects had a COPD diagnosis based on The Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (e.g., age 3 40 years old, smoker or ex-smoker, spirometry test). Sociodemographic, clinical, and COPD-related
variables were collected using questionnaires and medical records. Multivariate analysis using multiple logistic regression was
performed to measure the association between the use of the flu vaccine and acute exacerbations of COPD. Results: One
hundred twelve patients were included, with a median age of 70 years (interquartile range: 63.5-75.0 years). Of these, 37.5%
were vaccinated against flu, and 51.79% had at least one COPD exacerbation. In the adjusted analysis, being vaccinated the
previous year with the flu vaccine was not significatively associated with fewer exacerbations (OR=0.49, 95% CI 0.15-1.57;
p=0.230), whereas being vaccinated three consecutive previous years was associated with significative fewer exacerbations
(OR=0.13, 95% CI 0.02-0.91; p=0.040). The mean cost of an inpatient COPD exacerbation was USD 7,150.70. Conclusions:
This study did not show a statistically significant relationship between having flu vaccination the previous year and fewer
COPD exacerbations in Peruvian patients, which was the primary study objective; however, this shows a statistically significant
relationship between the use of three consecutive flu vaccines and fewer exacerbations.