The Pharmaceutical Journal Vol 267 No 7176 p767-773
1 December 2001

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Influenza vaccination does not worsen asthma

Administering inactivated influenza vaccine to adults and children with asthma, including those with severe asthma, is safe, say researchers from the United States.

As in the United Kingdom, guidelines in the US recommend annual vaccination against influenza for those of all ages with asthma. However, evidence from trials about the safety of vaccination in those with asthma has been conflicting and uptake of the vaccine in the US remains low in this group of patients. A spokesman for the National Asthma Campaign told The Journal that it was impossible to say how many asthma patients receive vaccination in the UK each year.

In the new study, researchers from American Lung Association asthma clinical research centres conducted a trial involving 2,032 patients with asthma to test the safety of the inactivated influenza vaccine. They assigned patients to receive an injection of the vaccine and an injection of placebo in random order with four weeks between the two injections.

For two weeks following each injection, recipients recorded peak expiratory flow rates, use of asthma medicines and symptoms thought to be related to the injection. The researchers found that the frequency of asthma exacerbations was similar after both injection of the vaccine and injection of placebo (28.8 per cent and 27.7 per cent, respectively). In addition, the researchers found no difference between the vaccine and placebo injection for other asthma-related outcomes. They comment that the rates of exacerbations of asthma after both injections were higher than expected and that this might reflect the belief that immunisation induces symptoms.

No difference in symptoms thought to be associated with vaccination was found other than a higher incidence of reported body aches after injection with the vaccine.

The researchers suggest that health care providers should urge patients with asthma to be immunised against influenza thereby reducing the morbidity and mortality associated with the disease in this group of patients (New England Journal of Medicine 2001:345:1529).

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