Vaccinations in Adult Pulmonary Practice

Most vaccine-preventable diseases are spread from person to person, which means that if one person in a community gets an infectious disease, they can spread it to others. Vaccination is the most effective technique to help stop the spread of several diseases. A vaccine-preventable disease has a lower risk of spreading if enough people receive vaccinations, keeping everyone healthy. Infectious respiratory diseases such as Influenza, COVID-19, and RSV spread from person to person. Find out how your immune system responds to various infections and about some of the typical side effects you could encounter. Vaccinations play a critical role in adult pulmonary practice, offering a proactive approach to preventing respiratory infections and complications.

Vaccinations are crucial for lowering the risk of serious infections like influenza and pneumococcal pneumonia in people with chronic lung diseases like COPD, asthma, and interstitial lung disease. These preventive measures not only enhance patient outcomes but also decrease hospitalizations and healthcare costs. Dr. Sheetu Singh guide on vaccinations in adult pulmonary practice serves as an invaluable resource for healthcare providers aiming to enhance patient care in the respiratory field.

Her guide emphasizes the importance of immunizations in lowering morbidity, mortality, and medical expenses while offering specific advice on how to administer important vaccinations, such as Pneumococcal and influenza shots.

Influenza Vaccines 

• Available Vaccines: 

• • • Vaccine against Inactivated Influenza (IIV). Path: IM. It consists of 
      • Recombinant trivalent and 
      • Quadrivalent influenza vaccines.  
    • Influenza vaccination using live attenuation (LAIV). Route: Intranasal
    • Dose – 0.5 ml sc/im once annually 

• Coad ministration: 

• • If LAIV, MMR, or yellow fever vaccinations are among the live virus shots that need to be administered, they ought to be administered on the same day. 
  • Give them at least 28 days apart if they are not given on the same day (30 days if you have yellow fever). 
  • Additional components and subunits, such as PCV13, Shingles (Herpes Zoster), etc., may be included when necessary or recommended.

Influenza Vaccines: Contraindications 

• Contraindications for LAIV: 

• • Age ≥50yrs
  • pregnant women
  • history of allergic reaction to any excipients of the vaccine or eggs
  • Immunocompromised status
  • received antiviral therapy in ≤48hrs
  • Caregivers for patients with weakened immune systems who need an isolated environment
  • Patients with Guillain Barre Syndrome, Asthma, Chronic conditions, etc. 

Influenza Vaccines: Key Considerations

• Adults who have not had the vaccination should get it throughout the duration of the influenza season, particularly if the virus is active in the neighborhood at certain times. 
  • before the monsoon season in southern parts of India 
  • before the winter season in northern parts of India
• Given that B/Yamagata strains have not been discovered in India after March 2020, trivalent vaccinations should be chosen over tetravalent vaccines when they are available. 
• The B/Victoria lineage has been connected to all type B viruses discovered after March 2020. 

How Vaccines Work 

There are several kinds of vaccines. Some still include disease-causing bacteria, but they’ve been rendered inert or weakened. Others (like the synthetic messenger RNA used in some COVID-19 vaccines) contain either the genetic material of the germ or a harmless portion of it. Your immune system is boosted by a vaccine, which causes you to create the same antibodies you would if you were exposed to the actual illness. It helps your body learn to recognize and fight an invasion of a particular germ. Consequently, you can acquire immunity to that illness without first contracting it. 

What Respiratory Diseases Have Vaccines?

There are vaccines for some infectious respiratory diseases, including:

• Influenza.
• COVID-19.
• Pertussis (Whooping Cough).
• Pneumonia.
• Tuberculosis (TB), has limited use in the United States.
• Respiratory Syncytial Virus (RSV).

Some infectious respiratory diseases do not yet have vaccines, including:

• Common Cold.

Why Vaccinations are Important for Adults with Lung Disease 

Individuals who suffer from respiratory conditions like COPD or Asthma may be more vulnerable to severe illnesses that can be prevented by vaccination. It’s critical to maintain current immunization records for the following diseases for optimal protection:

• COVID-19- to protect against severe COVID-10 illness.
• Pneumococcal Pneumonia- to protect against the most common type of bacterial pneumonia.
• Influenza- to protect against season flu each year.
• Tdap: to guard against whooping cough, diphtheria, and tetanus.
• RSV- To protect against severe RSV illness in adults 60+.
• Zoster- To protect against shingles.

Diseases that can be prevented by vaccinations can result in hospital stays, long-term sickness, the worsening of pre-existing chronic disorders, and even death. Make sure you have received all of the required immunizations by speaking with your healthcare practitioner.

BCG Vaccination

• In India, the BCG vaccination has been administered to newborns since 1978. 
• Demonstrated to be a secure and reliable vaccine for reducing childhood TB mortality and severe types of the disease.

Need For Adult BCG Vaccination

• The possible advantages of BCG revaccination, or “boosting,” outside of the pediatric age group have drawn attention back to BCG.
• A reanalysis of the Chingleput BCG vaccine study revealed that, after 15 years, BCG immunization in a community provided only moderate protection against the onset of tuberculosis (36% efficaciousness).
• Another study among adults in India cited BCG revaccination as immunogenic.

BCG Re-Vaccination Study

• Vaccinating susceptible adult populations with BCG is a crucial intervention that may help lower the number of new TB cases in the community.
• The Government of India is conducting this study to increase immunity and provide protection against tuberculosis (TB) in adults, as immunity to the disease declines with time.  
• To further reduce the risk of tuberculosis (TB) in vulnerable adults, the Ministry of Health & Family Welfare, Government of India, in collaboration with State Governments and Union Territories (UTs), has agreed to administer the adult BCG vaccine.  
• Adult BCG vaccinations are now being provided as part of the trial to 
  • >60 years of age 
  • > 18 years old and meeting any of the following requirements:
    • History of TB in the last 5 years.
    • Intimate ties to a case of active tuberculosis (DSTB/DRTB)/
    • Body Mass Index less than 18 KG/ meter square.
    • Self-reported smokers (current/past)
    • known case of Diabetes Mellitus
• The adult BCG immunization will not be provided as part of the trial to those who are 
  • Pregnant / Lactating
  • Currently on TB treatment / TB preventive treatment
  • Possess illnesses such as HIV, or cancer, are taking immunosuppressive drugs, or have received a transplant.
  • Currently sick/ seriously ill/ bed ridden
  • Having received blood transfusions within the prior three months.
  • Possess a medical history of serious responses to BCG or any other vaccinations.
  • Who engage in high-risk activities, such as prostitutes or injectable drug users.

FAQs

Why are vaccinations important for adults with chronic lung diseases?

Adults with long-term lung disorders such as asthma and COPD should get vaccinated against infections since these infections can worsen the disease and cause serious consequences, hospital stays, and even death. Vaccines such as the flu and Pneumococcal vaccines reduce the risk of respiratory infections that can significantly impact lung health.

Which vaccinations are recommended for adults with chronic pulmonary conditions?

Adults with chronic lung problems are advised to have the annual influenza vaccination, Tdap (tetanus, diphtheria, and pertussis), COVID-19, and pneumococcal vaccines (PCV13 and PPSV23). Depending on the individual’s health status, other vaccines like the shingles vaccine (for those over 50) and Hepatitis B vaccine may also be advised.

Can Vaccinations cause adverse effects in adults with lung diseases?

While vaccines can cause mild side effects like soreness at the injection site, fever, or, fatigue, serious adverse effects are rare. The advantages of immunization in preventing serious respiratory infections for persons with lung disorders greatly exceed the possibility of adverse effects. It’s important to discuss any concerns with a healthcare provider to ensure safe vaccination.

How often should adults with chronic lung conditions receive the flu vaccine?

Adults with chronic lung conditions should receive the flu vaccine annually. The best defense against the most recent strains of the influenza virus is provided by an annual vaccination, as the virus varies every year.

Are there any specific contraindications for vaccinations in adults with lung diseases?

Severe adverse reactions to a prior dosage or to any part of the vaccine are contraindications for immunization. Additionally, certain vaccines may be contraindicated or postponed in individuals with acute moderate or severe illness. A healthcare professional should be consulted to assess the appropriateness of vaccinations in light of individual medical histories.