Response to pneumococcal vaccine in chronic obstructive lung disease--the effect of ongoing, systemic steroid treatment

Vaccine. 2006 Feb 27;24(9):1408-12. doi: 10.1016/j.vaccine.2005.09.020. Epub 2005 Sep 26.


Forty-nine patients with chronic obstructive lung disease (COPD) were block-randomized in four groups to investigate, if different degrees of steroid-load influenced the effect of pneumococcal-vaccination on antibody level and clinical variables during 6 months of follow-up. The groups included 13 patients without systemic steroids for the previous 3 months, all vaccinated at entrance in the study and treated with steroids for 4 weeks. Nine patients had chronic steroid treatment both before and during the investigation; they were vaccinated at the entrance in the study. Fifteen patients without systemic steroids for the previous 3 months were vaccinated after the end of a 4-week steroid treatment. Twelve patients served as controls, and were not vaccinated. Totally, 60%-78% of vaccinated patients in the three groups had a rise in antibody level, and a later decrease compared to two of the 12 control patients (p<0.01). This difference was also significant (p<0.05) for the patients vaccinated at entrance in the hospital. No differences were observed among the clinical variables: pneumonia, exacerbations, admittance to hospital, increase in the use of steroids or beta-agonists, and the use of antibiotics. We conclude that a rise in antibody level after pneumococcal vaccination can be expected in patients with COPD despite of the use of systemic steroids. The clinical effect of vaccination is debatable.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumococcal Vaccines / administration & dosage
  • Pneumococcal Vaccines / antagonists & inhibitors
  • Pneumococcal Vaccines / immunology*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / immunology
  • Steroids / administration & dosage
  • Steroids / therapeutic use*


  • Antibodies, Bacterial
  • Pneumococcal Vaccines
  • Steroids