P2. Immunisations

P2.1 Influenza immunisation

Vaccination reduces the risks associated with influenza and pneumococcal infection [evidence level I, strong recommendation].

In people aged 65 years and older, annual influenza immunisation reduces the development of severe respiratory complications and hospitalisations or death from both respiratory disease and all causes by about 50% (Nichol 1994). In people with COPD, inactivated influenza vaccine reduces exacerbations due to influenza, especially in epidemic years (Poole 2006) [evidence level I]. Adverse effects are mild, local, transient and self-limiting and include sore arm, mild fever and arthralgia. There is no increase in early exacerbations before immunity has developed. The vaccine strains are adjusted annually based on epidemiological data. It should be given in early autumn to all patients with moderate to severe COPD (Nichol 1994, Poole 2006). Annual influenza vaccination is highly cost-effective, particularly in patients with more severe COPD (Poole 2006).