SERUM ANTIBODY-RESPONSE TO INFLUENZA VACCINE IN PULMONARY PATIENTS RECEIVING CORTICOSTEROIDS

Objective: Despite the recommendation that patients with chronic lung diseases-many of whom receive corticosteroids-receive annual influenza vaccination, it is not known whether corticosteroids influence antibo dy response to influenza vaccine in this population. The purpose of th is study was to assess whether patients with pulmonary conditions rece iving long-term corticosteroid therapy develop an adequate antibody re sponse. Design: We prospectively studied 39 consecutive candidates for influenza vaccination, 25 of whom were receiving corticosteroids for underlying lung diseases. Patients with immunosuppression besides cort icosteroids were excluded. Serum samples were obtained prior to and 1 month after vaccination with inactivated trivalent influenza vaccine a nd assayed for antibodies to the three strains using a hemagglutinatio n inhibition assay. No patients had any intercurrent illness compatibl e with influenza during the study period and patients receiving cortic osteroids continued treatment with them during this time. Results: A f ourfold rise in antibody titer at 1 month to at least one component wa s seen in 21 of 25 (84%) of corticosteroid-treated patients, which was similar to patients not receiving corticosteroids (11/14, 79%). There was no corticosteroid-antibody, dose-response relationship. Conclusio ns: Patients with pulmonary conditions receiving corticosteroids can g enerate an adequate antibody response to killed influenza virus vaccin e. Long-term therapy with corticosteroids should not preclude influenz a vaccination in patients with chronic pulmonary diseases who are deem ed vaccine candidates.