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A5032 - Analysis of the Effectiveness of Vaccination with Conjugated Pneumococcal Vaccine in Patients with Chronic Obstructive Pulmonary Disease in 4 Years of Observation
Author Block: G. Ignatova, V. Antonov; Therapy, South Ural State Medical University, Chelyabinsk, Russian Federation.
Relevance: In recent years there have been changes in the approaches and concepts of vaccine prevention. Priority is given to the study of the effectiveness of vaccination with pneumococcal conjugate vaccine. The target of the study was to analyze prospective clinical and cost-effectiveness of vaccine prophylaxis with conjugated pneumococcal vaccine Prevenar 13 (PCV13) in patients with COPD for 4 years. Material and methods: The study included 394 male patients treated or observed in the Clinical Hospital No.4 and the City Pulmonary Center in Chelyabinsk from 2012 to 2016. Patients are divided into 3 groups: the 1st group was vaccinated with PCV13, 2nd unvaccinated, 3rd - with PPV23. The number of exacerbations of COPD, hospitalizations, the number of cases of pneumonia development, the degree of dyspnea, and functional indices were analyzed. Prognostic evaluation indices of BODE, DOSE, ADO were calculated. The cost-effectiveness of vaccination was assessed. Results and Conclusions: In groups of vaccinated patients compared with unvaccinated patients (group 2) after 1 year of observation there was a significant decrease in the degree of dyspnea on the MRC scale. However, by the fourth year of observation, differences were observed: in the group of vaccinated PCV13 the dynamics of dyspnea reduction persisted, and in the PPV23 group dyspnea practically returned to baseline values. The dynamics of FEV1 has a similar tendency. In vaccinated patients in both groups (1 and 3) after a year of observation the number of exacerbations decreased 6.5 times - from 130 to 25 cases in the PCV13 group and from 25 to 4 in the PPV23 group. In patients vaccinated with PCV13 after 3 years the number of exacerbations compared to the first year after vaccination did not change significantly, that is the effectiveness of vaccination is maintained at least during this time. The number of pneumonias decreases on PCV13 3-fold by the first year of observation and remains on these figures after 4 years. After the application of PPV23 the number of pneumonia returns to baseline after 4 years. Prognostic indices BODE, DOSE, ADO have a significant, statistically significant, tendency to decrease in a year, with the effect remaining after four years of follow-up in patients after vaccination with PCV13. By maintaining the effect throughout the four years of observation vaccination with PCV13 minimizes the number of exacerbations of COPD, the incidence of pneumonia and the cost of the health system by 78.5% per year.