PNEUMOCOCCAL VACCINATION IN COPD

Pneumococcal disease is a major public health problem and is important in patients with chronic obstructive pulmonary disease (COPD). Although the pneumococcal polysaccharide vaccine (PPV) has been available for some time, there has been debate as to its effectivesness, particularly in the elderly and other at risk groups. In this month’s Thorax we publish a randomised controlled trial by Alfageme and colleagues on the use of the 23-valent PPV in COPD patients, with community acquired pneumonia (CAP) as the primary outcome. Overall, there were no significant differences in CAP between the intervention and non-intervention groups and the efficacy of the vaccine in the whole group was 24%. However, in patients under 65 years and in those with more severe airflow obstruction, PPV was effective in preventing CAP. The authors conclude that younger COPD patients with more severe disease need vaccination. In the accompanying editorial Hall discusses the UK policy of vaccinating all …