Influenza vaccination

What it is

A yearly influenza vaccine is one of the two important vaccinations in COPD; the other is pneumococcus with a 5 year booster. What is shown to improve mortality in COPD is quitting smoking, which slows the rate of FEV1 decline, and continuous O2 therapy >18 hrs/day. Vaccination also changes what causes CAP: Haemophilus influenzae is less common in the era of vaccination against this bacterium.

Pregnancy is one of the groups in which the vaccine is given. The vaccines given during pregnancy are influenza; Tdap, that is tetanus, diphtheria and acellular pertussis, at 27-36 weeks gestation; and the COVID-19 vaccine; alongside tetanus toxoid in 5 doses, hepatitis A, hepatitis B or inactivated typhoid vaccine if indicated, and meningococcal polysaccharide vaccine only if indicated. What is contraindicated in pregnancy is the live-attenuated group, that is MMR, varicella and oral polio, together with HPV. So for a pregnant woman influenza is the vaccine that is both given during pregnancy and not among the contraindicated live-attenuated ones. The vaccine itself comes in two forms. The inactivated influenza vaccine is given by the IM route; the live attenuated influenza vaccine is given by the intranasal route, and the live one is contraindicated in the immunocompromised, in children under 2 yr of age and in pregnancy. Current vaccines are trivalent and consist of two subtypes of influenza A and one subtype of influenza B; elsewhere the viruses in it are given as influenza A(H3N2), pandemic A(H1N1) and both influenza B lineage viruses, and the vaccine is called trivalent or quadrivalent inactivated. The type given routinely to children and the type given to the elderly and at risk groups are different, live against inactivated, and that is what explains their different contraindications.