In recent years, following the COVID-19 pandemic and the recent seasonal epidemic of acute respiratory infections, the importance of vaccination has become more evident, especially among those groups considered vulnerable, such as people with respiratory diseases such as asthma or COPD. Respiratory patients have a greater predisposition to suffer complications and, in this context, immunization is presented as an asset capable of changing the epidemiological scenario, avoiding hospitalizations and associated complications and, ultimately, improving the quality of life of these people.
These are some of the conclusions drawn from one of the tables of the 32nd Winter Meeting of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), which brought together in Burgos, on February 9 and 10, professionals from all over the country with the aim of promoting the exchange of information and experiences among SEPAR members. Specifically, the talk ‘Immunization in the respiratory patient‘ highlighted the importance of vaccination in these people or the need to develop new vaccines to move towards a future “where we can prevent more diseases”, as highlighted by the new president of the society, David de la Rosa Carrillo.
Immunization, however, is not without important challenges, such as the reluctance of some groups towards vaccines. “At this time, we are witnessing a certain degree of lack of adherence to vaccines among the adult population,” as he explained. José María Eiros-Bouza, director of the National Influenza Center of Valladolid; who was accompanied by Rosario Menendez Villanueva, head of the Pulmonology Service at the La Fe University and Polytechnic Hospital; and Felipe Villar Alvarezassociate head of the Pulmonology Service at the Jiménez Díaz Foundation University Hospital.
“At this time, we are witnessing a certain degree of lack of adherence to vaccines among the adult population”
José María Eiros-Bouza
In his speech, Eiros-Bouza highlighted the importance of centers such as the one in Valladolid, one of the laboratories recognized by the World Health Organization to carry out surveillance for influenza and other respiratory viruses; dedicated, among other tasks, to characterization, the study of immunogenicity and epidemiological notification to health authorities. “Our job, in addition to monitoring the immune response, is to study the genetic sequence of viruses, such as the flu, necessary for the WHO to issue its recommendations for the composition of vaccines for the corresponding season.”
On the other hand, the microbiologist highlighted that of every five patients who are diagnosed with flu, one has a coinfection, with the respiratory syncytial virus (RSV) being “a great candidate for coinfection.” Thus, he called to be prepared because, “in case there is a ‘catastrophic’ flu, the only tool that could help us alleviate this crisis is vaccination.” In this sense, he stressed that flu vaccination among health workers is declining and defended that these professionals “have to set an example” for the population and raise awareness about the importance of immunization. In fact, he highlighted that one of the studies promoted by the National Flu Center of Valladolid showed that the vaccine worked better in those who had received a previous vaccination.
COPD and asthma
About the flu, Felipe Villar Alvarez He recalled that there are sufficient studies to support that the flu vaccine reduces COPD exacerbations due to this cause, as well as to reduce asthma attacks. In his speech, titled ‘Vaccination in chronic respiratory patients‘, the pulmonologist explained which vaccines are recommended and for which patients. In this sense, he explained that both COPD and asthma are risk factors when acquiring an influenza infection. “These infections, especially in the young population, cause symptoms in the upper airway. But the most susceptible population, including those with chronic respiratory pathology, can have complications such as bronchospasms or pneumonia, which can not only end in hospitalization, but even in an intermediate respiratory care unit (ICU) or an ICU,” he explained. to Medical Gazette.
Thus, Villar Álvarez stressed that, in addition to the flu vaccination, it is recommended that patients with COPD and asthma also be immunized against the flu. pneumococcus, herpes zoster (HZ) and whooping cough (dTpa), the latter, every ten years for adults, whether or not they have underlying respiratory pathology. Regarding pneumococcus, the specialist stressed that, both in patients who previously had the PCV13 vaccine and those who have the polysaccharide, it is advisable to administer PCV20, since in both cases it increases the effectiveness compared to not giving it. In any case, he recalled that “neither the vaccine nor natural immunity provides total protection,” but contributes to reducing the incidence of infection, as well as the associated complications.
Felipe Villar Álvarez, during his speech.
The pulmonologist pointed out that patients with COPD and asthma are also at greater risk of contracting HZ as well as developing complications after the infection, especially postherpetic neuralgia (PHN), which is very disabling for the patient. Although HZ may seem far from the spectrum of respiratory pathologies, Villar Álvarez clarified that “It has an important place in chronic respiratory patients, whether in COPD, asthma or immunosuppressed patients.”, so immunization against this virus with the recombinant vaccine is advisable for these people.
The shingles vaccine, as well as one of the new vaccines approved against RSV for adults, “share in their composition an adjuvant system that substantially improves the response to the vaccine in immunosuppressed and elderly patients.” As Villar Álvarez explained, “the presence of this adjuvant achieves a higher and more prolonged response in these patients”. Precisely, he highlighted that these two characteristics, effectiveness and durability, are “essential” in any vaccine, in addition to “sufficiently high vaccination rates being achieved; That is to say, that both the Ministry and the different Health ministries facilitate access to vaccines for the largest possible population.”
Scenario of greatest pathology
For its part, Rosario Menendez Villanueva He explained that the HZ virus remains latent in our sensory nervous ganglia and specified that its moment of maximum expression is after the age of 60. Regarding the available vaccine, the head of the Pulmonology Service at La Fe Hospital highlighted that the efficacy levels are “frankly excellent”; above 90 percent against associated complications. Thus, she defended that “we must act” in the face of the scenario that is presented, “of greater incidence due to the aging of the population.” Along these lines, she stated that the peaks of respiratory syncytial virus of recent seasons have caused damage, “and not only to children.” In this context, vaccination can help protect people over 60 years of age from serious cases of RSV, as demonstrated by the latest vaccines approved against this disease.
“In children, we have everything well structured: what vaccines to give and when. This must also be established in adults”
Felipe Villar Alvarez
Definitely, “We increasingly have more tools, from the point of view of prevention, to combat these infectious diseases.”, as Villar Álvarez highlighted to Gaceta Médica. For this reason, the pulmonologist defended the need to establish a specific vaccination schedule for adults. “In children, we have everything well structured: what vaccines to give and when. This must also be established in adults, especially in adults with chronic respiratory pathology. This also means that we have to facilitate vaccination, not only in health centers, but in hospitals. We must have a good health structure to be able to provide vaccination to all our patients, as well as the population in general,” the expert concluded.
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2024-02-14 09:58:59
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