Clinical Edge

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Efficacy of Influenza Vaccine for COPD

Cochrane Library; ePub 2018 Jun 26; Kopsaftis, et al

Inactivated influenza vaccine reduced exacerbations in individuals with chronic obstructive pulmonary disease (COPD), according to a recent Cochrane review. 11 randomized clinical trials (RCTs) with 6,750 participants that compared live or inactivated virus vaccines with placebo, either alone or with another vaccine, in people with COPD were included. Only 6 of the RCTs with 2,469 participants included people with COPD. Among the findings:

  • Moderate-quality evidence found that inactivated influenza reduced exacerbations in people with COPD.
  • There was a mild increase in transient local adverse effects with vaccination, but no evidence of an increase in early exacerbations.
  • Addition of live attenuated virus to the inactivated vaccine was not shown to confer additional benefit.


Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No.: CD002733. doi:10.1002/14651858.CD002733.pub3.


The outcome of this study is really of no surprise since we recommend a flu vaccine to everyone in the US over the age of 6 months. It is estimated that about two-thirds of the economic burden of vaccine preventable diseases occurs with influenza. Most likely the biggest impact of the influenza vaccine is seen in our high-risk patients. Influenza infection can certainly lead to COPD exacerbations. A 2007 study from Japan, in the journal Vaccine, showed that in patients over 65 years of age, the influenza vaccine decreased mortality from COPD by 45%. Along with pneumococcal vaccine, an annual influenza vaccine is an important part of the primary prevention in patients with COPD. —John Russell, MD