Vaccination against pneumococcal infection as a tool to reduce mortality in patients with COPD and IHD

Introduction. Ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) are currently major contributors to morbidity and mortality in the Russian Federation and worldwide. Preventive programs that include the use of pneumococcal vaccines, primarily the 13-valent pneumococcal conjugate vaccine, are widely recognized tools in managing patients with comorbid conditions. Aim. To assess the clinical efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in patients with COPD and IHD over a 10-year follow-up period. Materials and methods. The study included a total of 500 male patients diagnosed with COPD and IHD who received treatment or were under observation at the Pulmonology Center in Chelyabinsk. Patients were divided into three groups. The first group consisted of 149 vaccinated patients with isolated COPD (without IHD); the second group included 175 vaccinated patients with both COPD and IHD; the third group comprised 176 unvaccinated patients with COPD. The 13-valent pneumococcal conjugate vaccine (Prevnar 13) was used. The primary endpoint over the 10-year follow-up was the number of developed pneumonias. Secondary endpoints included the number of exacerbations, hospitalizations, and all-cause mortality. Results and conclusions. Vaccination with PCV13 significantly improved patient survival over at least a 10-year observation period. The use of the conjugate pneumococcal vaccine led to a significant reduction in the incidence of community-acquired pneumonia in patients with COPD, as well as in those with combined COPD and IHD. Vaccination resulted in the stabilization of key clinical and functional parameters, even over a 10-year period. Including pneumococcal vaccines in clinical guidelines for patients with comorbid COPD and IHD should be mandatory and prioritized.

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