Vaccines show multiple positive effects with respect to respiratory health

Vaccines show both direct and indirect positive effects and are particularly important to prevent respiratory diseases.

Population protection by vaccination against infections has been one of the major achievements of public health and is of considerable importance in controlling respiratory disease. “Vaccines are able to protect patients against infections and reduce the number of episodes and complications in particular in patients at risk,” said Dr Rosario Menéndez (University Hospital La Fe, Spain) [1].

Globally, lower respiratory tract infections are the fourth most common cause of death [2]. In Europe, the annual incidence of community-acquired pneumonia has been estimated at 1.07-1.2 cases per 1,000 persons per year. However, in people ≥65 years, this incidence increases to 14 cases per 1,000 persons per year [3]. A systematic review and meta-analysis published this year revealed that the burden of pneumonia requiring hospitalisation among older adults is substantial. Based on data from 52 hospital studies reporting data on pneumonia mortality, the authors estimated that about 1.1 million in-hospital deaths occurred among older adults from 1996 through 2017 [4]. “One important aspect is that viruses facilitate bacterial infections,” said Dr Menéndez. Several mechanisms contribute to this effect, such as epithelial damage, increased capillary permeability, and reduced phagocytosis [5].

Vaccines, such as influenza vaccines, are effective in reducing hospitalisations, both in the general population as well as in chronic obstructive pulmonary disease patients [6,7]. In addition, they can reduce the transmission and control the disease spread, and can counteract antimicrobial resistance through multiple pathways [8]. They reduce both appropriate and inappropriate use of antimicrobials by reducing overall disease incidence, including infections caused by viruses that are often inappropriately treated with antibiotics.

Additional indirect benefits

In addition, influenza and pneumococcal infections increase cardiovascular risk. Although data are not yet consistent, there is a suggested beneficial effect of vaccinations in the prevention of cardiovascular events [9]. By reducing community-acquired pneumonia, vaccinations can prevent the vicious circle in which pneumonia drives unhealthy aging (see Figure). “So, it is our responsibility to contribute to an increasing awareness of vaccination among patients and vaccinators,” concluded Dr Menéndez.

Figure: A vicious cycle of unhealthy aging—the self-amplifying cycle of interactions between pneumonia and comorbidities [10]

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   1. Menéndez R. Oral abstract 3750, ERS 2019, 29 Sept-2 Oct, Madrid, Spain.
   2. Lozano R, et al. Lancet 2012;380(9859):2095-2128.
   3. Torres A, et al. Thorax 2013;68(11): 1057-65.
   4. Shi T, et al. J Infect Dis 2019 Mar 8. pii: jiz053. doi: 10.1093/infdis/jiz053.
   5. Paget C & Trottein F. Front Immunol 2019;10:336. doi: 10.3389/fimmu.2019.00336.
   6. Rolfes MA, et al. Clin Infect Dis 2019;69(11):1845-1853.
   7. Mulpuru S, et al. Chest 2019;155(1):69-78.
   8. Lipsitch M & Siber GR. MBio 2016;7: pii: e00428-16. Doi: 10.1128/mBio.00428-16.
   9. Fountoulaki K, et al. Cardiology 2018;141(2):98-106.
   10. Quinton LJ, et al. Physiol Rev 2018;98(3):1417-1464.

 



Posted on 28 November 201917 March 2021