Enhancing uptake of respiratory vaccinations in asthma and chronic obstructive pulmonary disease (COPD) patients: a systematic review.

Clinical Snapshot

Key Findings

• P Value: Nine of eleven studies showed statistically significant improvements

• Effect Size: Not quantified - narrative synthesis only

• Primary Outcome: Respiratory vaccination rates (influenza and pneumococcal)

• Nnt Or Sensitivity: Not calculated due to inability to perform meta-analysis

• Confidence Interval: Not applicable - no meta-analysis performed

Clinical Application

Patient education interventions appear feasible but require healthcare professional involvement and systematic implementation Relevant to Australian practice given similar healthcare structure; could inform RACGP vaccination guidelines and support PBS-funded vaccination programs for chronic disease patients Adults with COPD or asthma in healthcare settings where patient education interventions can be implemented

Abstract

INTRODUCTION: Despite influenza, pneumococcal and COVID vaccines being widely recommended for patients with chronic respiratory disease, vaccination rates in this cohort remain low. The aim of this systematic review is to identify interventions which are effective in increasing respiratory vaccination rates in adults with chronic obstructive pulmonary disease (COPD) or asthma. METHODS: The inclusion and exclusion criteria for the study can be found in the PROSPERO protocol (PROSPERO registration no: CRD42025588565). A search was run across four databases (MEDLINE, Embase, CENTRAL and ClinicalTrials.gov) in February 2025, which returned 2537 studies. Eleven studies were deemed to meet the study inclusion/exclusion criteria and these were narratively synthesised: four randomised clinical trials (RCTs), six longitudinal studies and one observational cohort study. Risk of bias was assessed using the Cochrane's Risk of Bias (RoB-V2) and ROBIN-I-V2 tools. Studies were categorised according to the COM-B model of behaviour change. RESULTS: All 11 studies consisted of COPD populations, with four studies also including asthma patients. Interventions focused on patient education, with/without involvement of a healthcare professional (HCP). Nine of the eleven studies showed a statistically significant improvement in influenza and/or pneumococcal vaccination rate with an intervention. No studies assessing COVID vaccine uptake in this population were suitable for inclusion. Most studies targeted patients' capability to get vaccinated through improving patients' and HCPs' knowledge. Fewer studies focused on social opportunity (e.g. support from other patients/HCPs) or automatic motivation (e.g. reminders). DISCUSSION: The published literature in this area is currently limited. Most studies are non-randomised and are at high-risk of bias, making meta-analysis not possible. Further research should assess the practicalities (physical opportunity) of vaccination, especially in low-income economies (where most respiratory patients reside) and standardising research methods to allow for future meta-analysis. OTHER: There is no funding for this review.

References

1. 1.Gulati, R. R., Yaqub, F., & Goodman, A. L. (2026). Enhancing uptake of respiratory vaccinations in asthma and chronic obstructive pulmonary disease (COPD) patients: a systematic review. Vaccine, Article 128560. https://doi.org/10.1016/j.vaccine.2026.128560