Vaccination against Streptococcus pneumoniae is among the most effective measures for preventing pneumonia and reducing the rate of chronic obstructive pulmonary disease (COPD) exacerbations. The objective of this work was to evaluate the long-term effectiveness of PCV13 and PPV23 for preventing pneumonia and COPD exacerbations. The open-label, prospective, observational cohort study involved 302 male patients aged ≥ 45 years: PCV13 group (n = 123); PPV23 group (n = 32); and vaccine-naïve group (n = 147). The primary endpoint included the frequency of pneumonia episodes and COPD exacerbations per year over a 5-year follow-up period. The secondary endpoints included the dynamics of dyspnea severity (MMRC), the BODE index, FEV1, the CAT index, the SGRQ score, and the results of 6-min walk test. Vaccination with PCV13 and PPV23 significantly reduces the total rate of pneumonia during the first year after vaccination. Starting with the second year, clinical effectiveness in PPV23 group decreases compared with both PCV13 group and vaccine-naïve patients. Pneumonia by year 5 after vaccination was registered in 47% of patients in the PPV23 group, versus 3.3% of patients in the PCV13 group (p < 0.001); COPD exacerbations—in 81.3% versus 23.6%, respectively (p < 0.001). Vaccination with PCV13 significantly reduced and maintained the BODE index over the 5-year follow-up period. Although both vaccines have comparable clinical effects during the first year after vaccination, only PCV13 is characterized by persistent clinical effectiveness during the 5-year follow-up period. Patients older than 55 years who received PPV23 have significantly higher risks of having pneumonia episodes more frequently during the long-term follow-up.

Most subjects with the COVID-19 experience mild to moderate symptoms, but approximately 10% of cases suffer from severe course of disease. IL-6 inhibitors are actively used to neutralize and prevent the cytokine storm. Olokizumab is a humanized monoclonal antibody belonging to the G4/Kappa immunoglobulin isotype that selectively binds to human IL-6 and effectively neutralizes it. Aim.To evaluate the efficacy and safety of Artlegia (olokizumab) for the treatment of subjects with a disease caused by the SARS-COV-2 virus in a real-world clinical setting. Materials and methods.The analysis included data of 610 subjects aged 55.0812.68 years who received olokizumab at a single dose of 160 mg/mL 0.4 mL subcutaneously as a preemptive anti-inflammatory therapy. The comparison group included 511 subjects aged 55.2311.23 years who received standard therapy without IL-6 inhibitors. Control Endpoints: 1. Positive clinical changes on Day 7. 2. Changes in the CRP levels on Days 1, 2, and 7. 3. Duration of oxygen therapy. 4. Number of days in hospital. 5. Number of adverse events. 6. Disease outcome. Results.If a cytokine storm occurs, immune regulatory events will trigger the development of either a protective immune response or an exacerbated inflammatory response. The use of preemptive anti-inflammatory therapy has both a short-term and, most importantly, a long-term effect on the T and B parts of the immune process. These aspects definitely require further research and observation. Conclusion.The use of olokizumab to treat the new COVID-19 coronavirus disease has demonstrated a positive effect on clinical and laboratory parameters. Primarily, it affects the severity of clinical parameters by improving the general condition already on the first day of observation, and decreasing body temperature to normal values. The changes in the C-reactive protein levels show a significant effect of the IL-6 inhibitor on the systemic inflammatory response.

Immunoprophylaxis is one of the most effective tools for reducing morbidity and mortality from infectious diseases. In the context of global epidemiological challenges and increased population mobility, the issues of managing immunization, proper patient selection, safety and effectiveness of vaccination are of particular importance. The document systematizes modern approaches to organizing and conducting vaccination of adults. It includes sections on planning and vaccination techniques, contraindications and "false contraindications", features of vaccination against specific infections (influenza, pneumococcal infection, hepatitis, diphtheria, tetanus, poliomyelitis, measles, rubella, etc.), as well as vaccination in pregnant women and military personnel. Particular attention is paid to the registration and treatment of post-vaccination reactions and complications, and the costeffectiveness of vaccination. The guidelines are intended for general practitioners, infectious disease specialists, epidemiologists, pediatricians, and public health specialists.

Major problems in the course of chronic obstructive pulmonary disease (COPD) include frequent exacerbations and related deaths. The use of pneumococcal vaccines, primarily a 13-valent polysaccharide conjugate vaccine, is a generally recognized tool for reducing the number of exacerbations.The aim of the study was to analyze the prospective clinical efficacy of vaccine prophylaxis with conjugated pneumococcal vaccine Prevenar-13 (PCV13) in patients with COPD over 10 years.Methods. A total of 362 male patients who were treated or monitored at the Regional Pulmonological Center of Chelyabinsk in 2012 – 2022 were enrolled in the study. The main efficacy endpoints of observation over 10 years were: the dynamics of dyspnea (mMRC score), forced expiratory volume in 1st second, the number of exacerbations, hospitalizations, the number of pneumonias. After confirming the diagnosis of COPD, the patients were divided into two observation groups. The first group (n = 150) included patients vaccinated with PCV13. The second group (n = 212) included patients with COPD who had not received pneumococcal vaccination for various reasons.Results. Severe forms of the disease and frequent exacerbations predominated in both groups. 96 (27%) deaths were recorded in the PCV13-vaccinated group, and 171 (47%) deaths in the unvaccinated group. The difference between vaccinated and unvaccinated is statistically significant (p < 0.05). In the unvaccinated patients, there was a steady progression of shortness of breath with an increase by 12% compared to baseline (p < 0.05) by the 10^th year. A positive trend in FEV1 was noted in patients vaccinated with PCV13. They also showed a significant decrease in BODE prognostic index.Conclusion. The use of PCV13 allows for stabilization of the main clinical and functional indicators of the respiratory system in patients with COPD in the long term (at least 10 years of follow-up). Vaccination maintains a low risk of adverse events according to the BODE index; an increase in patient survival was noted over a 10-year horizon (odds ratio – 2.35; 95% confidence interval – 1.45; 3.77), including cases with acute viral damage with COVID-19 (COronaVIrus Disease 2019).

В статье приводятся данные об анализе клинической и фармакоэкономической эффективности применения конъюгированной пневмококковой вакцины у пациентов с хронической обструктивной болезнью легких (ХОБЛ) на протяжении 5 лет наблюдения. Материалы и методы. В исследование включены пациенты мужского пола (n = 394) с диагнозом ХОБЛ. Основными конечными точками наблюдения для оценки эффективности явились динамика показателей по модифицированной шкале одышки (Modified Medical Research Council – mMRC), объема форсированного выдоха за 1-ю секунду, количества обострений, госпитализаций, числа пневмоний. Рассчитан также прогностический оценочный индекс BODE. У всех пациентов проведен анализ медикаментозной терапии. Для вакцинопрофилактики использовались пневмококковая конъюгированная 13-валентная вакцина (ПКВ-13) Превенар-13 и пневмококковая полисахаридная 23-валентная вакцина (ППВ-23) Пневмо-23. Результаты. Установлено, что при включении в план ведения пациентов с ХОБЛ вакцинопрофилактики ПКВ-13 уменьшается степень одышки и стабилизируются основные функциональные показатели респираторной системы не только в краткосрочный период, но и на протяжении как минимум 5 лет наблюдения. Показано, что вакцинация ПКВ-13 наряду с бронходилатацией может рассматриваться в качестве базисной терапии. При вакцинопрофилактике Превенар-13 уменьшается риск неблагоприятных событий при ХОБЛ и повышается выживаемость пациентов. Заключение. Продемонстрировано, что вакцинация с применением ПКВ-13 за счет сохранения эффекта на протяжении 4 лет наблюдения позволяет минимизировать число обострений ХОБЛ, заболеваемость пневмонией и расходы системы...

The article uses the analysis of clinical and pharmacoeconomic effectiveness of 13-valent conjugated pneumococcal vaccine in patients with combined course of chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and chronic heart failure (CHF). Materials and methods. 429 male patients with diagnoses of COPD, IHD, CHF were included in the study. The main endpoints of observation, for 5 years, for evaluation of effectiveness were dynamic assessment for class CHF, the number of exacerbations, hospitalizations, the number of pneumonias. The 13-valent conjugated pneumococcal vaccine (PCV13) Prevenar-13 was used for vaccine prophylaxis. Results and discussion. The increase in age with the combined course of COPD and cardiovascular pathology leads to a deterioration in the basic clinical and functional indicators. With the increase in the clinical symptoms of the defeat of the respiratory system. There is an increase in the functional class of heart failure. Inclusion of vaccine prophylaxis PCV13 in the management plan of patients with combined pathology. Reduce the degree of dyspnea and stabilize the main functional indicators. Conclusions. Vaccination of patients with COPD using PCV13 combined with CHF and IHD made it possible to manage the health system expenses by 74–84%. Keywords: chronic obstructive pulmonary disease, ischemic heart disease, chronic heart failure, vaccine prophylaxis, conjugated vaccine.