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).

The article for the first time provides a relatively comprehensive overview of the main aspects of the epidemiology and clinical features of infectious pathology, i.e., community-acquired pneumonia, as comorbid and aggravating conditions in patients with type 1 and type 2 diabetes mellitus. Risk factors and pathogenetic patterns of infectious processes development, as well as the special etiological role of pneumococcal infection in this group of patients, are considered. Particular attention is paid to the possibilities of and approaches to the primary prevention of vaccine-preventable infections as the causes of the development of community-acquired pneumonia and invasive diseases in patients with diabetes mellitus with a review of international studies, guidelines, and local experience data in pneumococcal infection immunization.

Relevance. Patients with diabetes mellitus have an increased risk of developing various infections, including those of the lower respiratory tract. Immunization with anti-pneumococcal vaccines reduces pneumonia-related hospitalizations and deaths.Aim. Evaluate the cost-effectiveness of vaccination against pneumococcal infection in 40and 65-year-old patients with type 2 diabetes mellitus (DM2).Material and methods. The analysis was carried out from the perspective of the healthcare system. The Markov model based on Russian epidemiological data, taking into account the results of foreign studies, was used. Vaccination schedules with 1 dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 1 dose of pneumococcal 23-valent polysaccharide vaccine (PPV23) and vaccination with only 1 dose of PCV13 were evaluated. The time horizon of the study is 5 years. Costs and life expectancy were discounted by 3.5% per year.Results. Vaccination of 65-year-old patients with type 2 diabetes is characterized by extremely high cost-effectiveness (the incremental cost effectiveness ratio – ICER – for PCV13+PPV23 vaccination is 189.27 thousand rubles/QALY, and PCV13 vaccination entails a cost reduction of 371.92 rubles per 1 vaccinated). When vaccinating 40-year-old patients, the ICER for PCV13 + PPV23 vaccination is 491.31 thousand rubles/QALY, and for PCV13 – 55.31 thousand rubles/QALY.Conclusion. Vaccination against pneumococcal disease in 40and 65-year-old patients with DM2 reduces the associated morbidity and mortality and is highly cost-effective. Compared to PCV13 vaccination alone, vaccination with PCV13 followed by the introduction of PPV23 provides an increase in the number of prevented cases of the disease and the deaths caused by it, but at the same time requires additional costs.

Introduction. Ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) are currently major contributors to morbidity and mortality in the Russian Federation and worldwide. Preventive programs that include the use of pneumococcal vaccines, primarily the 13-valent pneumococcal conjugate vaccine, are widely recognized tools in managing patients with comorbid conditions. Aim. To assess the clinical efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in patients with COPD and IHD over a 10-year follow-up period. Materials and methods. The study included a total of 500 male patients diagnosed with COPD and IHD who received treatment or were under observation at the Pulmonology Center in Chelyabinsk. Patients were divided into three groups. The first group consisted of 149 vaccinated patients with isolated COPD (without IHD); the second group included 175 vaccinated patients with both COPD and IHD; the third group comprised 176 unvaccinated patients with COPD. The 13-valent pneumococcal conjugate vaccine (Prevnar 13) was used. The primary endpoint over the 10-year follow-up was the number of developed pneumonias. Secondary endpoints included the number of exacerbations, hospitalizations, and all-cause mortality. Results and conclusions. Vaccination with PCV13 significantly improved patient survival over at least a 10-year observation period. The use of the conjugate pneumococcal vaccine led to a significant reduction in the incidence of community-acquired pneumonia in patients with COPD, as well as in those with combined COPD and IHD. Vaccination resulted in the stabilization of key clinical and functional parameters, even over a 10-year period. Including pneumococcal vaccines in clinical guidelines for patients with comorbid COPD and IHD should be mandatory and prioritized.

The article presents data on the analysis of the clinical efficacy of vaccination against pneumococcal infection in patients with chronic obstructive pulmonary disease (COPD) in combination with type 2 diabetes mellitus during a 5 years follow-up period. Materials and methods. The study included patients (n=103) with COPD in combination with type 2 diabetes. Primary endpoints were changes dyspnea mMRC score, FEV1, number of exacerbations of COPD, hospitalizations, and a rate of pneumonia. The prognostic indices BODE, DOSE, ADO were also calculated. 13-valent conjugate pneumococcal vaccine PCV-13 and 23-valent polysaccharide vaccine PPV-23 were used for vaccination. Results. It has been established that when vaccination is included in the management plan for patients with COPD in combination with diabetes, the severity of dyspnea decreases, the lung function stabilize both for short-term and 5-years follow-up. Vaccination with PCV-13 and PPV-23 reduce number of exacerbations, a rate of pneumonia and hospitalizations, but long-term efficacy has been demonstrated only for PCV-13. Vaccination with PCV-13 can improve the quality of life and prognosis for patients with COPD in combination with type 2 diabetes. Conclusion. Vaccination of pneumococcal infection in patients with COPD and type 2 diabetes mellitus can reduce the number of exacerbations, incidence of pneumonia and the number of hospitalizations, improve the prognosis and survival of patients using PCV-13 by maintaining efficacy for 5 years of follow-up.

Background: COPD and stable angina are common in older adults, increasing the risk of respiratory and cardiovascular complications. Pneumococcal vaccination is recommended to reduce this burden. This study evaluated the 10-year impact of 13-valent pneumococcal conjugate vaccine (PCV13) on community-acquired pneumonia (COPD), COPD exacerbations, hospitalizations, and survival in this cohort. Methods: A total of 483 male patients with COPD and/or stable angina received a single dose of PCV13 and were divided into three groups: Group 1 (n = 140): vaccinated with COPD; Group 2 (n = 167): vaccinated with COPD and stable angina; and Group 3 (n = 176): unvaccinated with COPD. Primary endpoints were CAP cases, COPD exacerbations, and hospitalizations; the secondary endpoint was survival. Analysis used generalized linear models, Cox regression, and Kaplan–Meier survival curves. Results: PCV13 significantly reduced CAP in patients with COPD alone but not in those with comorbid angina. Although CAP, exacerbations, and hospitalizations increased over time, vaccinated groups consistently showed lower rates than the unvaccinated group. Survival was higher in both vaccinated groups over 10 years. Conclusions: PCV13 was associated with a reduced risk of CAP, COPD exacerbations, hospitalizations, and improved survival in older adults with COPD and stable angina. These findings support the vaccine’s potential to improve outcomes in multimorbid populations and its inclusion in clinical guidelines and adult immunization programs for high-risk older adults.