Influenza and pneumococcal vaccination rates across FACED severity categories in bronchiectasis

Abstract Background Bronchiectasis is a chronic and heterogeneous airway disease in which prevention of exacerbations is a key component of management. Although influenza and pneumococcal vaccination are strongly recommended in this population, real-world vaccination rates remain suboptimal. Vaccination coverage across different levels of bronchiectasis severity has not been well characterized. This study aimed to determine influenza and pneumococcal vaccination rates in patients with bronchiectasis and to compare vaccination coverage across disease severity categories assessed by the FACED score. Methods This retrospective observational cohort study included 589 patients with bronchiectasis followed between 2024 and 2025. Demographic, clinical, radiological, and vaccination data were obtained from electronic medical records and national vaccination registries. Bronchiectasis severity was assessed using the FACED score and categorized as mild, moderate, or severe. Influenza vaccination was defined as receiving at least one dose during the 2024–2025 influenza season, and pneumococcal vaccination was defined as having received PCV13 and/or PPSV23. Statistical analyses included chi-square tests, linear-by-linear association, and multivariable logistic regression. Results The mean age of the patients was 55.3 ± 14.9 years, and 57.6% were male. Influenza and pneumococcal vaccination rates were 21.2% and 62.6%, respectively. Vaccination rates increased significantly with disease severity for both influenza (16.4%, 27.3%, and 32.5% for mild, moderate, and severe groups, respectively; p = 0.001) and pneumococcal vaccines (58.5%, 60.8%, and 85.0%, respectively; p < 0.001), with a significant linear trend (p for trend < 0.001 for both). In multivariable analysis, mild disease severity and age < 65 years were independently associated with lower likelihood of both influenza and pneumococcal vaccination, whereas sex was not a significant predictor. Conclusions Vaccination rates in patients with bronchiectasis increase with disease severity but remain insufficient, particularly in those with mild disease. These findings highlight the need for early and comprehensive vaccination strategies across all stages of bronchiectasis.