Vaccination in adult patients with chronic lung diseases

In Switzerland, additional vaccinations against influenza, COVID-19, Streptococcus pneumoniae and varicella zoster virus (VZV), are recommended for patients with chronic lung diseases such as COPD, asthma or interstitial lung disease, since infectious diseases often lead to exacerbation of lung diseases resulting in increased disease burden and mortality. In this review we give an overview on recommended vaccinations for patients with chronic lung diseases, also including vaccinations against pertussis and RSV, which are recommended in international guidelines. While continuous development of vaccines against S. pneumoniae has given rise to high-valency vaccines covering up to 68% of S. pneumoniae variants in individuals aged ≥65 years, vaccination rates in this age group remain low in Switzerland (10% in 2020). Vaccination rates are higher for influenza, and particularly high-dose vaccines account for high vaccination efficacy in years of low strain matching in individuals at risk. Although mortality of COVID-19 decreased since the emergence of the first SARS-CoV-2 variant, patients with chronic lung disease are still at increased risk for exacerbation, unless vaccinated with variant-adjusted vaccines. VZV and Bordetella pertussis vaccination has also significantly countered reactivation and infection rates, respectively, and subunit vaccines against VZV show long duration. However, pertussis vaccination is still limited by its fast waning. A glimpse into the future presumes the introduction of new higher-valence vaccinations against S. pneumoniae, and several types of RSV vaccines are expected to enter the Swiss market soon.