title: Adverse effects associated with influenza vaccination in patients with COPD: a randomized controlled study.
abstract: OBJECTIVE
  The aim of this study was to assess the frequency and type of adverse reactions following influenza vaccination and its effects on lung function, dyspnoeic symptoms, exercise capacity, and clinical acute respiratory illness (ARI) in patients with COPD, and the relationship of these adverse effects to the degree of airflow obstruction.
  
  
  METHODS
  A stratified, randomized, double-blind placebo-controlled study was conducted over an 18-month period at a single university hospital. In total, 125 patients with COPD were randomized to the vaccine group (62 patients who received purified trivalent split-virus vaccine injections) or the placebo group (63 patients). Local and systemic symptoms during the week following the injections were evaluated. Clinical ARI, lung function tests, dyspnoeic symptoms (assessed using a visual analogue scale), and a 6-min walking test were evaluated before and at 1 week and 4 weeks following vaccination.
  
  
  RESULTS
  The frequency of local adverse reactions was 27% in the vaccine group and 6% in the placebo group (P = 0.002). There was no significant difference in systemic adverse reactions between the vaccine and placebo groups (76% vs. 81%; P= 0.5). No difference was observed in the incidence of ARI between the vaccine and placebo groups during the first week (6.4% vs. 6.3%; P= 1) and the first 4 weeks (24.2% vs. 31.7%; P= 0.5) following vaccination. There was no significant change in lung function, dyspnoeic symptoms, and exercise capacity of the patients in both groups, at 1 week and 4 weeks following vaccination, regardless of the severity of COPD.
  
  
  CONCLUSIONS
  Influenza vaccination is associated with minimal local adverse reactions in patients with COPD. Vaccination does not cause systemic adverse reactions, induce clinical exacerbations or adversely affect lung function, dyspnoeic symptoms and exercise capacity in patients with COPD, regardless of the severity of airflow obstruction.
authors.affiliation: Division of Respiratory Disease and Tuberculosis, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sipwo@mahidol.ac.th
authors.forename: Phunsup
authors.initials: P
authors.lastname: Wongsurakiat
authors.forename: Khun Nanta
authors.initials: KN
authors.lastname: Maranetra
authors.forename: Penpun
authors.initials: P
authors.lastname: Gulprasutdilog
authors.forename: Monchai
authors.initials: M
authors.lastname: Aksornint
authors.forename: Wichian
authors.initials: W
authors.lastname: Srilum
authors.forename: Chairat
authors.initials: C
authors.lastname: Ruengjam
authors.forename: Wichean
authors.initials: W
authors.lastname: Sated
mesh_terms: D000208:Acute Disease; D000368:Aged; D004311:Double-Blind Method; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects*; D007251:Influenza, Human / Q000150:complications* / Q000517:prevention & control*; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000209:etiology
chemical_list: D007252:Influenza Vaccines