R E V I E W Prevention and control of inﬂuenza in persons with chronic obstructive pulmonary disease Pedro Plans-Rubió General Direction of Public Health, Travessera Corts, Barcelona, Spain Correspondence: Pedro Plans-Rubió General Direction of Public Health, Travessera Corts 131-159, Barcelona 08028, Spain Tel +34 9 3227 2900 Fax +34 9 3227 2990 Email pedro.plans@gencat.net Abstract: Despite recommendations for annual vaccination against inﬂuenza, more than half of patients with chronic obstructive pulmonary disease (COPD) in developed countries do not receive this vaccine. Inﬂuenza is characterized by its potentially of causing epidemics and by excess morbidity and mortality in patients with COPD and other chronic medical conditions. Good evidence of the efﬁcacy, effectiveness, and cost-effectiveness of inﬂuenza vaccination underlines the recommendation of use in patients with COPD. Inﬂuenza vaccination could reduce inﬂuenza-related complications and exacerbations in patients with COPD, therefore reducing hospitalizations and deaths. Each year, all persons with COPD should be vaccinated with the inactivated trivalent inﬂuenza vaccine containing the most frequent two inﬂuenza A viral strains and one inﬂuenza B viral strain detected in the inﬂuenza season of the previous year. To achieve a 100% vaccination rate in patients with COPD, all patients with COPD registered in health insurance companies and attended in health centers and specialized clinics should be vaccinated during the immunization period (October–December). Antiviral therapies could be used as an adjunct to vaccination and to reduce inﬂuenza transmission in outbreaks. Antiviral therapies could reduce the duration and complications of inﬂuenza when administered within two days of the onset of illness. Research is necessary for new antiviral therapies that could prevent inﬂuenza with cost-effectiveness similar to the inﬂuenza vaccine. Keywords: influenza vaccination, chronic obstructive pulmonary disease, vaccination program Introduction Inﬂuenza is an acute respiratory disease that causes epidemics and pandemics in the human populations from temperate regions. Inﬂuenza epidemics occur every year dur- ing winter months, affecting 10%–20% of the population (Cox and Subbarao 1999). Inﬂuenza viruses also can cause pandemics, during which rates of illness and death from inﬂuenza-related complications increase worldwide. Incidence rates of inﬂuenza infection vary with the nature of the virus strains and the population affected. Rates of serious illness are highest among persons aged 65 years, children aged <2 years, and persons with high-risk conditions for inﬂuenza-related complications, such as chronic obstructive pulmonary disease (COPD) (Barker 1986; Thompson et al 2003; Glezen et al 2000). Inﬂuenza vaccination is the primary method of prevention and control of inﬂuenza in persons with COPD. It can reduce inﬂuenza-related respiratory illness, physician visits, hospitalization, and death (OTA 1981; Patriarca et al 1986; Heikkinen et al 1991; Mullooly et al 1994; Gross et al 1995; Bridges 2000; Anthonisen 2002). Inﬂuenza vaccination levels increased during the 1990s, but they are lower than 50% in high-risk patients in the US and other developed countries (Harper et al 2005). The objectives of this article are to review the evidence supporting the inﬂuenza vaccination in patients International Journal of COPD 2007:2(1) 41–53 © 2007 Dove Medical Press Limited. All rights reserved 41