{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:34:07Z","timestamp":1792020847751,"version":"4.4.0"},"reference-count":133,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent key events in the natural history of COPD and are associated with several adverse outcomes. Respiratory infections are major and potentially modifiable triggers of ECOPD, with viral pathogens such as the influenza virus, respiratory syncytial virus (RSV), and SARS-CoV-2, as well as bacterial infections caused by Streptococcus pneumoniae, playing a central role. This narrative review examines the current evidence supporting vaccination as a preventive strategy for ECOPD and discusses its translation into clinical practice. The biological rationale for vaccination in COPD is reviewed, including disease-related immune dysregulation, impaired mucociliary clearance, and increased susceptibility to respiratory pathogens. Evidence from randomized clinical trials, observational studies, meta-analyses, and real-world data is summarized for pneumococcal, influenza, SARS-CoV-2, and RSV vaccines. Pneumococcal vaccination has been shown to reduce the burden of community-acquired pneumonia and invasive pneumococcal disease, with conjugate and higher-valent vaccines providing enhanced immunogenicity in older and high-risk adults. Influenza vaccination consistently reduces severe exacerbations, hospitalizations, and mortality, with additional cardioprotective effects of relevance in COPD. SARS-CoV-2 vaccination markedly lowers the risk of severe COVID-19 and related respiratory deterioration in COPD, while recently licensed RSV vaccines offer a novel opportunity to prevent RSV-associated lower respiratory tract disease and potentially reduce exacerbation risk. Patient populations most likely to benefit from vaccination include frequent exacerbators, older adults, individuals with severe airflow limitation, multimorbidity, immune dysfunction, infection-prone phenotypes, and socially vulnerable groups. Future perspectives include precision vaccination strategies, novel vaccine platforms, coadministration approaches, and interventions to improve vaccine uptake. Vaccination emerges as a cornerstone of ECOPD prevention, with substantial potential to reduce exacerbation burden and improve long-term outcomes in COPD.<\/jats:p>","DOI":"10.1055\/a-2837-8778","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T23:53:45Z","timestamp":1774310025000},"page":"323-333","source":"Crossref","is-referenced-by-count":2,"title":["Role of Vaccination in the Prevention of ECOPD"],"prefix":"10.1055","volume":"47","author":[{"given":"Filippo","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7298-7084","authenticated-orcid":false,"given":"Ernesto","family":"Crisafulli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcial","family":"Cariqueo","sequence":"additional","affiliation":[{"name":"Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Di Chiara","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fantin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy"},{"name":"Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[{"name":"Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/S2213-2600(24)00413-2","article-title":"GOLD COPD report: 2025 update","volume":"13","author":"P Venkatesan","year":"2025","journal-title":"Lancet Respir Med"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/resp.14041","article-title":"Chronic obstructive pulmonary disease exacerbation 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