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14-07-2013 | Infectious disease | Article

Spirometry boosts influenza vaccination in COPD


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medwireNews: Increasing the use of spirometry could help increase the rate of influenza vaccination among patients with chronic obstructive pulmonary disease (COPD), say researchers.

Their study, published in PLoS One, shows that patients whose diagnosis was confirmed by spirometry were nearly one-third more likely to have had the vaccination – which is deemed essential for COPD patients – in the previous year.

“This research provides evidence that a breathing test is a critical component of care associated with increased vaccination rates and therefore can impact influenza-related exacerbations,” say authors Melissa Zullo (Kent State University, Cleveland, Ohio, USA) and colleagues.

Using data on 16,309 COPD patients taken from the 2011 US Behavioral Risk Factor Surveillance System survey, the authors found that 49% had received an influenza vaccination in the past 12 months – well below the national target of 90% for high-risk individuals and the over 65s.

But among the 13,201 (78%) patients who had undergone a breathing test, this rate was still significantly higher, at 53% compared with 36% among patients who had not undergone the testing. In adjusted analyses, this equated to a 31% greater likelihood for influenza vaccine among spirometry-tested patients.

The researchers say that their study adds to growing evidence that rates of vaccination are low among COPD patients but that it is the first to suggest spirometry as a means to improve this.

However, they caution that spirometry alone would not bring the vaccination rate close to the desired 90%. There are multiple barriers to vaccination among COPD patients which could include the perception of low risk, the fear of side effects, and the fear of contracting influenza. Additionally, some patients, and indeed physicians, express concern that the vaccine could trigger exacerbations prior to the development of immunity.

Given that up to 36% of COPD exacerbations are thought to be attributable to influenza and the proven efficacy of the vaccination in their prevention, “every effort should be made to ensure adults with COPD receive the influenza vaccine,” the authors conclude.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter

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