title: Should Patients With COPD Be Vaccinated?
abstract: BACKGROUND
  Exacerbations of COPD are a major component of the socioeconomic burden related to COPD, and frequent exacerbations are associated with greater decline in health status. Tracheobronchial infections are involved in 50-70% of exacerbations, so influenza and pneumococcal vaccines are recommended for prevention. The aim of this study was to determine the level of knowledge among COPD patients about the vaccines, find the rate of patients inoculated with both influenza and pneumococcal vaccines, and assess the effectiveness of vaccination status.
  
  
  METHODS
  Patients with COPD were recruited from the out-patient clinic of our hospital between September and October 2012. Subject demographic data such as age, gender, level of education, and smoking status were recorded. Vaccination status, number of subjects who were informed by a health-care professional about immunization, and COPD-related emergency or hospital admissions triggered by tracheobronchial infections over 1 y after administration of both influenza and pneumococcal vaccines were noted.
  
  
  RESULTS
  Eighty-eight subjects were enrolled during the study period. Eighty-two subjects were male (93.2%), 6 subjects were female (6.8%), and the median age was 61.5 y. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006 classification, 5 subjects were in stage 1 (5.7%), 22 subjects were in stage 2 (25%), 34 subjects were in stage 3 (38.6%), and 27 subjects were in stage 4 (30.7%). Sixty-two subjects had graduated from primary school (70.5%), 21 subjects had graduated from high school (23.9%), one subject had graduated from university (1.1%), and 4 subjects had no education (4.5%). Forty-five subjects (51%) were vaccinated. There was no significant correlation between level of education and vaccination status (P=.37). Both COPD-related emergency department and hospital visits were significantly decreased in vaccinated patients with COPD (P<.001 and P=.02, respectively). Of all the subjects, 39.7% (35 of 88 subjects) mentioned that no health-care professional recommended vaccination.
  
  
  CONCLUSIONS
  Physicians should be more aware of vaccination and recommend both influenza and pneumococcal vaccines to all patients with COPD to reduce exacerbations.
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Cimen
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey. lidokain21@hotmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Unlu
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Kirakli
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Nuran
authors.initials: N
authors.lastname: Katgi
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Fatma Demirci
authors.initials: FD
authors.lastname: Ucsular
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Aysu
authors.initials: A
authors.lastname: Ayranci
authors.affiliation: Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
authors.forename: Salih Zeki
authors.initials: SZ
authors.lastname: Guclu
mesh_terms: D000368:Aged; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000517:prevention & control*; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000150:complications*; D012720:Severity of Illness Index; D014611:Vaccination / Q000706:statistics & numerical data*
keywords: COPD; chronic obstructive pulmonary disease; immunization; influenza vaccination; pneumococcal vaccination