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Flu Vaccine Safe for Asthmatics

Despite official recommendations, an estimated 90 percent of asthmatic patients do not receive the influenza vaccine, possibly because results from some studies suggest that vaccination may exacerbate asthma. To evaluate this issue, researchers devised a double-blind crossover trial: Asthmatic subjects received 2 injections (1 influenza, 1 placebo), spaced a month apart, and were monitored for asthma exacerbations for 14 days after each injection.

A total of 1240 adults and 712 children completed the study. All had stable asthma, with no emergency asthma care or medication changes during the 2 weeks before study entry, although 40 percent to 50 percent had received such interventions within the previous year. Only 2 percent were taking oral steroids at study entry.

Overall rates of exacerbation -- defined as a 30 percent or greater decrease in peak expiratory flow, an urgent medical visit for asthma care, or intensification of asthma medication -- were equivalent in the vaccine and placebo groups (28.8 percent and 27.7 percent, respectively). None of these indicators differed between groups. Subgroup analyses based on severity of asthma, comorbidities (e.g., smoking, obesity), and demographic data (e.g., age, race, sex) also showed no difference between vaccine and placebo.

Comment: Although this study was conducted during a single flu season and included only 1 preparation of inactivated vaccine, the results do not support withholding flu vaccine from asthma patients, particularly because the benefits of preventing respiratory infections in this group are clear.

— A Zuger

Published in Journal Watch General Medicine November 30, 2001

Citation(s):

American Lung Association Asthma Clinical Research Centers. The safety of inactivated influenza vaccine in adults and children with asthma. N Engl J Med 2001 Nov 22 345 1529-1536.

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