Vaccinating high-risk patients against influenza: doing more to protect patients with asthma.

ABSTRACT Globally, asthma is a significant source of both morbidity and mortality. Patients with asthma frequently experience episodes ofexacerbation that necessitate the utilization of substantial healthcare resources. Viral infections of the respiratory tract in asthmatic patientshave been associated with an increase in acute exacerbations; in particular, infection with influenza virus leads to a rise in severe asthmaexacerbations that require hospitalization.Many influenza-triggered respiratory complications are unnecessary and can potentially be avoided by vaccination. Vaccination againstinfluenza has been established as an effective way of reducing general practitioner consultations, exacerbations, hospitalizations and deathsin asthma patients. For these reasons, major international healthcare organizations and national authorities recommend annual vaccinationagainst influenza for patients with high-risk medical conditions, including the subpopulation of asthmatic patients.Despite the availability of safe and effective vaccines against influenza, vaccination rates remain lower than desirable, even among targetedhigh-risk populations, depriving these patients of protection against influenza and unnecessarily exposing them to influenza-relatedcomplications. Proactive strategies based on prevailing evidence-based international guidelines therefore need to be implemented toovercome barriers to vaccination and to extend protection against influenza to all high-risk patients, particularly those with asthma.Healthcare providers play a pivotal role in ensuring adherence to vaccination guidelines, thereby ensuring that these evidence-basedrecommendations are translated into improved outcomes for asthma patients.Keywords: Asthma, Exacerbation, Guidelines, High-risk, Influenza, Patients, Protect, VaccinationCorrespondence: Gernot Rohde, Medizinische Klinik III – Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin,Berufsgenossenschaftliches Universita¨tsklinikum Bergmannsheil GmbH, Haus 3 (Neubau), Raum 03.-1.007, Bu¨rkle-de-la-Camp-Platz 1, 44789Bochum, Germany. Tel: +49 (0)234 302 3532; Fax: +49 (0)234 302 6420; e-mail: gernot.rohde@ruhr-uni-bochum.de

[1]  M. Schwenkglenks,et al.  Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. , 2009, The Journal of infection.

[2]  Jiaquan Xu,et al.  Deaths: final data for 2006. , 2009, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[3]  T. Szucs,et al.  Increasing influenza vaccination coverage in recommended population groups in Europe , 2009, Expert review of vaccines.

[4]  Edward Ehlinger,et al.  Burden of influenza-like illness and effectiveness of influenza vaccination among working adults aged 50-64 years. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  G. Marseglia,et al.  Factors conditioning effectiveness of a reminder/recall system to improve influenza vaccination in asthmatic children. , 2009, Vaccine.

[6]  J. Fahy,et al.  Acute exacerbations of asthma: epidemiology, biology and the exacerbation‐prone phenotype , 2009, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[7]  Bruce A. Ong,et al.  Does Influenza Vaccination Improve Pediatric Asthma Outcomes? , 2009, The Journal of asthma : official journal of the Association for the Care of Asthma.

[8]  S. Esposito,et al.  The Global State of Influenza in Children , 2008, The Pediatric infectious disease journal.

[9]  I. Pin,et al.  Low influenza vaccination coverage in asthmatic children in France in 2006-7. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[10]  S. Johnston,et al.  Etiology of asthma exacerbations. , 2008, The Journal of allergy and clinical immunology.

[11]  G. Douglas.  Updated asthma guideline will improve outcomes. , 2008, The Practitioner.

[12]  Ethan A Halm,et al.  Barriers to adherence to asthma management guidelines among inner-city primary care providers. , 2008, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[13]  S. Galea,et al.  Project VIVA: a multilevel community-based intervention to increase influenza vaccination rates among hard-to-reach populations in New York City. , 2008, American journal of public health.

[14]  K. Poehling,et al.  Influenza Burden for Children With Asthma , 2008, Pediatrics.

[15]  R. Jiménez-García,et al.  Coverages and factors associated with influenza vaccination among subjects with chronic respiratory diseases in Spain. , 2007, European journal of public health.

[16]  E. Halm,et al.  Determinants of adherence to influenza vaccination among inner-city adults with persistent asthma. , 2007, Primary care respiratory journal : journal of the General Practice Airways Group.

[17]  C. Bridges,et al.  The annual impact of seasonal influenza in the US: measuring disease burden and costs. , 2007, Vaccine.

[18]  W. Carroll,et al.  Is there any evidence for influenza vaccination in children with asthma? , 2007, Archives of Disease in Childhood.

[19]  John Campbell,et al.  Influenza vaccination in patients with asthma: why is the uptake so low? , 2007, The British journal of general practice : the journal of the Royal College of General Practitioners.

[20]  W. P. Glezen,et al.  Asthma, influenza, and vaccination. , 2006, The Journal of allergy and clinical immunology.

[21]  P. Gibson,et al.  Asthma exacerbations · 3: Pathogenesis , 2006, Thorax.

[22]  A. Coffield,et al.  Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older. , 2006, American journal of preventive medicine.

[23]  A. Shefer,et al.  Influenza vaccination of high-risk children: what the providers say. , 2006, American journal of preventive medicine.

[24]  Keiji Fukuda,et al.  Influenza-associated deaths among children in the United States, 2003-2004. , 2005, The New England journal of medicine.

[25]  S. Bangdiwala,et al.  Racial and ethnic disparities in influenza vaccination among elderly adults , 2005, Journal of General Internal Medicine.

[26]  Siep Thomas,et al.  Influenza vaccination in children with asthma: no reason to change current recommendations. , 2005, American journal of respiratory and critical care medicine.

[27]  R. Jacobson,et al.  Requiring influenza vaccination for health care workers: seven truths we must accept. , 2005, Vaccine.

[28]  D. Grobbee,et al.  Clinical effectiveness of influenza vaccination in persons younger than 65 years with high-risk medical conditions: the PRISMA study. , 2005, Archives of internal medicine.

[29]  F. Sorvillo,et al.  A Multiple Cause-of-Death Analysis of Asthma Mortality in the United States, 1990–2001 , 2005, The Journal of asthma : official journal of the Association for the Care of Asthma.

[30]  D. Fabian,et al.  The global burden of asthma: executive summary of the GINA Dissemination Committee Report , 2004, Allergy.

[31]  Siep Thomas,et al.  Influenza vaccination in children with asthma: randomized double-blind placebo-controlled trial. , 2004, American journal of respiratory and critical care medicine.

[32]  M. Rangel,et al.  Prevalence and characteristics of children at increased risk for complications from influenza, United States, 2000. , 2004, The Journal of pediatrics.

[33]  K. Nichol,et al.  Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine. , 2003, Vaccine.

[34]  K. Nichol,et al.  The efficacy, effectiveness and cost-effectiveness of inactivated influenza virus vaccines. , 2003, Vaccine.

[35]  D. Fedson,et al.  Influenza vaccination in 2000: recommendations and vaccine use in 50 developed and rapidly developing countries. , 2003, Vaccine.

[36]  Alvin S. Teirstein,et al.  DIAGNOSIS OF LEGIONELLA INFECTION , 2002 .

[37]  M. Gaglani,et al.  Rationale and approach to target children with asthma for annual influenza immunization. , 2002, Seminars in pediatric infectious diseases.

[38]  Trang Vu,et al.  A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community. , 2002, Vaccine.

[39]  Stephen T Holgate,et al.  Frequency, severity, and duration of rhinovirus infections in asthmatic and non-asthmatic individuals: a longitudinal cohort study , 2002, The Lancet.

[40]  K. Neuzil,et al.  The burden of influenza illness in children with asthma and other chronic medical conditions. , 2000, The Journal of pediatrics.

[41]  W. Busse,et al.  The role of viral infections in the natural history of asthma. , 2000, The Journal of allergy and clinical immunology.

[42]  R. Davis,et al.  Influenza and the rates of hospitalization for respiratory disease among infants and young children. , 2000, The New England journal of medicine.

[43]  H. Teichtahl,et al.  The Incidence of Respiratory Tract Infection in Adults Requiring Hospitalization for Asthma , 1997, Chest.

[44]  E. D. de KLERK,et al.  Effect of experimental rhinovirus 16 colds on airway hyperresponsiveness to histamine and interleukin‐8 in nasal lavage in asthmatic subjects in vivo , 1997, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[45]  R. Loddenkemper,et al.  European Lung White Book. The first comprehensive survey on respiratory health in Europe. , 2003 .

[46]  T. Jefferson,et al.  Vaccines for preventing influenza in people with asthma. , 2000, The Cochrane database of systematic reviews.

[47]  C. Bridges,et al.  Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2000, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.