{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:19:30Z","timestamp":1773674370475,"version":"3.50.1"},"reference-count":117,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u00daNKP-23-4-New National Excellence Program of the Ministry for Culture and Innovation, the National Research, Development, and Innovation Fund","award":["\u00daNKP-23-4-SZTE-380"],"award-info":[{"award-number":["\u00daNKP-23-4-SZTE-380"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Chronic obstructive pulmonary disease (COPD) is a frequent, often progressive, chronic disease of the lungs. Patients with COPD often have impaired immunity; therefore, they are prone to chest infections, such as pneumonia or bronchitis. Acute exacerbations of COPD are major events that accelerate disease progression, contributing to its symptoms\u2019 burden, morbidity, and mortality. Both pneumonia and acute exacerbations in COPD are caused by bacteria against which there are effective vaccinations. Although the number of randomised controlled studies on bacterial vaccinations in COPD is limited, national and international guidelines endorse specific vaccinations in patients with COPD. This review will summarise the different types of vaccinations that prevent pneumonia and COPD exacerbations. We also discuss the results of early phase studies. We will mainly focus on Streptococcus pneumoniae, as this bacterium was predominantly investigated in COPD. However, we also review studies investigating vaccinations against Haemophilus influenzae, Moraxella catarrhalis, and Bordetella pertussis.<\/jats:p>","DOI":"10.3390\/vaccines12020213","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T05:39:56Z","timestamp":1708321196000},"page":"213","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Bacterial Vaccinations in Patients with Chronic Obstructive Pulmonary Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6792-6789","authenticated-orcid":false,"given":"D\u00f3ra","family":"Par\u00f3czai","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Szeged, H-6720 Szeged, Hungary"},{"name":"Albert Szent-Gy\u00f6rgyi Health Center, Department of Pulmonology, University of Szeged, H-6720 Szeged, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-2374","authenticated-orcid":false,"given":"Katalin","family":"Burian","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Szeged, H-6720 Szeged, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8983-740X","authenticated-orcid":false,"given":"Andras","family":"Bikov","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester M23 9LT, UK"},{"name":"Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,18]]},"reference":[{"key":"ref_1","unstructured":"(2023, July 08). 2023 GOLD Report. Available online: https:\/\/goldcopd.org\/2023-gold-report-2\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1136\/thx.2005.040527","article-title":"Severe Acute Exacerbations and Mortality in Patients with Chronic Obstructive Pulmonary Disease","volume":"60","author":"Salcedo","year":"2005","journal-title":"Thorax"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1164\/rccm.201104-0597OC","article-title":"Acute Exacerbations of Chronic Obstructive Pulmonary Disease","volume":"184","author":"Bafadhel","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15076","DOI":"10.1038\/nrdp.2015.76","article-title":"Chronic Obstructive Pulmonary Disease","volume":"1","author":"Barnes","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/nri3600","article-title":"Alveolar Macrophages: Plasticity in a Tissue-Specific Context","volume":"14","author":"Hussell","year":"2014","journal-title":"Nat. Rev. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2036","DOI":"10.1093\/infdis\/jit400","article-title":"Phagocytic Dysfunction of Human Alveolar Macrophages and Severity of Chronic Obstructive Pulmonary Disease","volume":"208","author":"Berenson","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1136\/thoraxjnl-2013-203669","article-title":"Impaired Innate Immune Alveolar Macrophage Response and the Predilection for COPD Exacerbations","volume":"69","author":"Berenson","year":"2014","journal-title":"Thorax"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1183\/09031936.00193908","article-title":"Pneumonia Risk in COPD Patients Receiving Inhaled Corticosteroids Alone or in Combination: TORCH Study Results","volume":"34","author":"Crim","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105950","DOI":"10.1016\/j.intimp.2019.105950","article-title":"Inhaled Corticosteroids and Risk of Pneumonia in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials","volume":"77","author":"Yang","year":"2019","journal-title":"Int. Immunopharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sonnappa, S., Martin, R., Israel, E., Postma, D., van Aalderen, W., Burden, A., Usmani, O.S., Price, D.B., and on behalf of the Respiratory Effectiveness Group, S.A.S.G. (2017). Risk of Pneumonia in Obstructive Lung Disease: A Real-Life Study Comparing Extra-Fine and Fine-Particle Inhaled Corticosteroids. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178112"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1056\/NEJMoa1104623","article-title":"Azithromycin for Prevention of Exacerbations of COPD","volume":"365","author":"Albert","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_12","unstructured":"(2023, December 17). Examples: Complete Pneumococcal Vaccine Schedules for Adults, Available online: https:\/\/www.cdc.gov\/vaccines\/vpd\/pneumo\/hcp\/pneumo-vaccine-timing.html."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1164\/rccm.200509-1525OC","article-title":"Airway Inflammation and Bronchial Bacterial Colonization in Chronic Obstructive Pulmonary Disease","volume":"173","author":"Sethi","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1056\/NEJMra0800353","article-title":"Infection in the Pathogenesis and Course of Chronic Obstructive Pulmonary Disease","volume":"359","author":"Sethi","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1089\/omi.2009.0100","article-title":"A Persistent and Diverse Airway Microbiota Present during Chronic Obstructive Pulmonary Disease Exacerbations","volume":"14","author":"Huang","year":"2010","journal-title":"OMICS"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/resp.12709","article-title":"Platelet-Activating Factor Receptor (PAFr) Is Upregulated in Small Airways and Alveoli of Smokers and COPD Patients","volume":"21","author":"Shukla","year":"2016","journal-title":"Respirology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12931-016-0483-8","article-title":"The Main Rhinovirus Respiratory Tract Adhesion Site (ICAM-1) Is Upregulated in Smokers and Patients with Chronic Airflow Limitation (CAL)","volume":"18","author":"Shukla","year":"2017","journal-title":"Respir. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1164\/rccm.200506-859OC","article-title":"Infections and Airway Inflammation in Chronic Obstructive Pulmonary Disease Severe Exacerbations","volume":"173","author":"Papi","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1183\/09031936.00109906","article-title":"Exacerbations of Chronic Obstructive Pulmonary Disease","volume":"29","author":"Celli","year":"2007","journal-title":"Eur. Respir. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1128\/CMR.00024-15","article-title":"Pneumococcal Capsules and Their Types: Past, Present, and Future","volume":"28","author":"Geno","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"22691","DOI":"10.3402\/ijch.v73.22691","article-title":"Impact of Pneumococcal Vaccines Use on Invasive Pneumococcal Disease in Nunavik (Quebec) from 1997 to 2010","volume":"73","author":"Lefebvre","year":"2014","journal-title":"Int. J. Circumpolar Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/1469-0691.12518","article-title":"The Role of Vaccination in Preventing Pneumococcal Disease in Adults","volume":"20","author":"Aliberti","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1093\/infdis\/jis703","article-title":"Pneumococcal Capsular Switching: A Historical Perspective","volume":"207","author":"Wyres","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"vii20","DOI":"10.1093\/jac\/dky157","article-title":"Molecular Characterization of Predominant Streptococcus Pneumoniae Serotypes Causing Invasive Infections in Canada: The SAVE Study, 2011\u20132015","volume":"73","author":"Golden","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Masomian, M., Ahmad, Z., Gew, L.T., and Poh, C.L. (2020). Development of Next Generation Streptococcus Pneumoniae Vaccines Conferring Broad Protection. Vaccines, 8.","DOI":"10.3390\/vaccines8010132"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.15585\/mmwr.mm6846a5","article-title":"Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged \u226565 Years: Updated Recommendations of the Advisory Committee on Immunization Practices","volume":"68","author":"Matanock","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1503\/cmaj.080734","article-title":"Efficacy of Pneumococcal Vaccination in Adults: A Meta-Analysis","volume":"180","author":"Huss","year":"2009","journal-title":"CMAJ"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tin Tin Htar, M., Stuurman, A.L., Ferreira, G., Alicino, C., Bollaerts, K., Paganino, C., Reinert, R.R., Schmitt, H.-J., Trucchi, C., and Vestraeten, T. (2017). Effectiveness of Pneumococcal Vaccines in Preventing Pneumonia in Adults, a Systematic Review and Meta-Analyses of Observational Studies. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177985"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/j.1468-1293.2009.00744.x","article-title":"A 5-Year Longitudinal Follow-up Study of Serological Responses to 23-Valent Pneumococcal Polysaccharide Vaccination among Patients with HIV Infection Who Received Highly Active Antiretroviral Therapy","volume":"11","author":"Hung","year":"2010","journal-title":"HIV Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1093\/infdis\/165.3.553","article-title":"Antibody to Capsular Polysaccharides of Streptococcus Pneumoniae after Vaccination of Human Immunodeficiency Virus-Infected Subjects with 23-Valent Pneumococcal Vaccine","volume":"165","author":"Musher","year":"1992","journal-title":"J. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1093\/infdis\/jis212","article-title":"Pneumococcal Conjugate and Plain Polysaccharide Vaccines Have Divergent Effects on Antigen-Specific B Cells","volume":"205","author":"Clutterbuck","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ingels, H.A.S., Kants\u00f8, B., and Slotved, H.-C. (2018). Serologic Response to Pneumococcal Vaccination in Children Experiencing Recurrent Invasive Pneumococcal Disease. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3267-6"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1093\/cid\/cir003","article-title":"A Randomized Study Comparing Combined Pneumococcal Conjugate and Polysaccharide Vaccination Schedules in Adults","volume":"52","author":"Lazarus","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1164\/rccm.200903-0488OC","article-title":"Superior Immune Response to Protein-Conjugate versus Free Pneumococcal Polysaccharide Vaccine in Chronic Obstructive Pulmonary Disease","volume":"180","author":"Dransfield","year":"2009","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1093\/cid\/cis513","article-title":"Long-Term Comparative Immunogenicity of Protein Conjugate and Free Polysaccharide Pneumococcal Vaccines in Chronic Obstructive Pulmonary Disease","volume":"55","author":"Dransfield","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1046\/j.1365-2249.2000.01109.x","article-title":"Conjugate Vaccines","volume":"119","author":"Goldblatt","year":"2000","journal-title":"Clin. Exp. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1586\/erv.09.113","article-title":"10-Valent Pneumococcal Nontypeable Haemophilus Influenzae PD Conjugate Vaccine: Synflorix","volume":"8","author":"Prymula","year":"2009","journal-title":"Expert. Rev. Vaccines"},{"key":"ref_38","unstructured":"(2012). Centers for Disease Control and Prevention (CDC) Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults with Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb. Mortal. Wkly. Rep., 61, 816\u2013819."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5195","DOI":"10.1016\/j.vaccine.2011.05.031","article-title":"A Randomized, Double-Blind Trial to Evaluate Immunogenicity and Safety of 13-Valent Pneumococcal Conjugate Vaccine given Concomitantly with Trivalent Influenza Vaccine in Adults Aged \u226565 Years","volume":"29","author":"Schwarz","year":"2011","journal-title":"Vaccine"},{"key":"ref_40","first-page":"CD001390","article-title":"Injectable Vaccines for Preventing Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease","volume":"10","author":"Walters","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.vaccine.2005.09.020","article-title":"Response to Pneumococcal Vaccine in Chronic Obstructive Lung Disease--the Effect of Ongoing, Systemic Steroid Treatment","volume":"24","author":"Steentoft","year":"2006","journal-title":"Vaccine"},{"key":"ref_42","first-page":"CD001390","article-title":"Pneumococcal Vaccines for Preventing Pneumonia in Chronic Obstructive Pulmonary Disease","volume":"1","author":"Walters","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1136\/thx.2005.043323","article-title":"Clinical Efficacy of Anti-Pneumococcal Vaccination in Patients with COPD","volume":"61","author":"Alfageme","year":"2006","journal-title":"Thorax"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S0140-6736(97)07358-3","article-title":"Randomised Trial of 23-Valent Pneumococcal Capsular Polysaccharide Vaccine in Prevention of Pneumonia in Middle-Aged and Elderly People. Swedish Pneumococcal Vaccination Study Group","volume":"351","author":"Ortqvist","year":"1998","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1056\/NEJMoa022678","article-title":"Effectiveness of Pneumococcal Polysaccharide Vaccine in Older Adults","volume":"348","author":"Jackson","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4435","DOI":"10.1016\/j.vaccine.2012.04.052","article-title":"Pneumococcal Polysaccharide 23-Valent Vaccine: Long-Term Persistence of Circulating Antibody and Immunogenicity and Safety after Revaccination in Adults","volume":"30","author":"Grabenstein","year":"2012","journal-title":"Vaccine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"109324","DOI":"10.1016\/j.clim.2023.109324","article-title":"Reduced Quantity and Function of Pneumococcal Antibodies Are Associated with Exacerbations of COPD in SPIROMICS","volume":"250","author":"LaFon","year":"2023","journal-title":"Clin. Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4284","DOI":"10.1016\/j.vaccine.2008.05.037","article-title":"Additive Effect of Pneumococcal Vaccine and Influenza Vaccine on Acute Exacerbation in Patients with Chronic Lung Disease","volume":"26","author":"Furumoto","year":"2008","journal-title":"Vaccine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1016\/S0264-410X(99)00114-0","article-title":"The Additive Benefits of Influenza and Pneumococcal Vaccinations during Influenza Seasons among Elderly Persons with Chronic Lung Disease","volume":"17","author":"Nichol","year":"1999","journal-title":"Vaccine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/1743-422X-5-52","article-title":"Effect of Influenza and Pneumococcal Vaccines in Elderly Persons in Years of Low Influenza Activity","volume":"5","author":"Christenson","year":"2008","journal-title":"Virol. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4233","DOI":"10.21037\/jtd-20-814","article-title":"Prevalence of Influenza and Pneumococcal Vaccination in Chronic Obstructive Pulmonary Disease Patients in Association with the Occurrence of Acute Exacerbations","volume":"12","author":"Fekete","year":"2020","journal-title":"J. Thorac. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/resp.14309","article-title":"Effectiveness of Influenza and Pneumococcal Vaccines on Chronic Obstructive Pulmonary Disease Exacerbations","volume":"27","author":"Li","year":"2022","journal-title":"Respirology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"5322","DOI":"10.1016\/j.vaccine.2022.07.033","article-title":"Immunogenicity and Safety of an Inactivated SARS-CoV-2 Vaccine (Sinopharm BBIBP-CorV) Coadministered with Quadrivalent Split-Virion Inactivated Influenza Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine in China: A Multicentre, Non-Inferiority, Open-Label, Randomised, Controlled, Phase 4 Trial","volume":"40","author":"Chen","year":"2022","journal-title":"Vaccine"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1378\/chest.92.2.204","article-title":"Pneumococcal Infection and Immunologic Response to Pneumococcal Vaccine in Chronic Obstructive Pulmonary Disease. A Pilot Study","volume":"92","author":"Davis","year":"1987","journal-title":"Chest"},{"key":"ref_55","first-page":"28","article-title":"The Clinical Aspects of Efficiency of the Prevention of Pneumococcal Infection with Vaccines in Chronic Obstructive Pulmonary Disease Patients Living in the West Siberian Region","volume":"86","author":"Kostinov","year":"2014","journal-title":"Ter. Arkhiv"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"15948","DOI":"10.1038\/s41598-021-95129-w","article-title":"Comparative Effectiveness of Pneumococcal Vaccination with PPV23 and PCV13 in COPD Patients over a 5-Year Follow-up Cohort Study","volume":"11","author":"Ignatova","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00006454-200003000-00003","article-title":"Efficacy, Safety and Immunogenicity of Heptavalent Pneumococcal Conjugate Vaccine in Children. Northern California Kaiser Permanente Vaccine Study Center Group","volume":"19","author":"Black","year":"2000","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4029","DOI":"10.1016\/j.vaccine.2007.02.062","article-title":"Immunogenicity of Varying Dosages of 7-Valent Pneumococcal Polysaccharide-Protein Conjugate Vaccine in Seniors Previously Vaccinated with 23-Valent Pneumococcal Polysaccharide Vaccine","volume":"25","author":"Jackson","year":"2007","journal-title":"Vaccine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/j.1365-2567.2006.02436.x","article-title":"The Kinetics and Phenotype of the Human B-Cell Response Following Immunization with a Heptavalent Pneumococcal-CRM Conjugate Vaccine","volume":"119","author":"Clutterbuck","year":"2006","journal-title":"Immunology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1086\/529142","article-title":"Comparison of Pneumococcal Conjugate Polysaccharide and Free Polysaccharide Vaccines in Elderly Adults: Conjugate Vaccine Elicits Improved Antibacterial Immune Responses and Immunological Memory","volume":"46","author":"Siber","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"6915","DOI":"10.1016\/j.vaccine.2010.08.004","article-title":"Circulating Pneumococcal Specific Plasma and Memory B Cells in the Elderly Two Years after Pneumococcal Conjugate versus Polysaccharide Vaccination","volume":"28","author":"Baxendale","year":"2010","journal-title":"Vaccine"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"4763","DOI":"10.1016\/j.vaccine.2010.04.103","article-title":"The Early Kinetics of Circulating Pneumococcal-Specific Memory B Cells Following Pneumococcal Conjugate and Plain Polysaccharide Vaccines in the Elderly","volume":"28","author":"Baxendale","year":"2010","journal-title":"Vaccine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"20631","DOI":"10.7448\/IAS.19.1.20631","article-title":"Long-Term Immune Responses and Comparative Effectiveness of One or Two Doses of 7-Valent Pneumococcal Conjugate Vaccine (PCV7) in HIV-Positive Adults in the Era of Combination Antiretroviral Therapy","volume":"19","author":"Cheng","year":"2016","journal-title":"J. Int. AIDS Soc."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1056\/NEJMoa1408544","article-title":"Polysaccharide Conjugate Vaccine against Pneumococcal Pneumonia in Adults","volume":"372","author":"Bonten","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.vaccine.2018.01.049","article-title":"Post Hoc Analysis of the Efficacy of the 13-Valent Pneumococcal Conjugate Vaccine against Vaccine-Type Community-Acquired Pneumonia in at-Risk Older Adults","volume":"36","author":"Suaya","year":"2018","journal-title":"Vaccine"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"60.e9","DOI":"10.1016\/j.cmi.2015.08.027","article-title":"Strain Features and Distributions in Pneumococci from Children with Invasive Disease before and after 13-Valent Conjugate Vaccine Implementation in the USA","volume":"22","author":"Metcalf","year":"2016","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/cid\/ciw067","article-title":"Prevention of Antibiotic-Nonsusceptible Invasive Pneumococcal Disease With the 13-Valent Pneumococcal Conjugate Vaccine","volume":"62","author":"Tomczyk","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"109","DOI":"10.15585\/mmwr.mm7104a1","article-title":"Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2022","volume":"71","author":"Kobayashi","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1080\/21645515.2018.1532249","article-title":"Safety and Immunogenicity of 15-Valent Pneumococcal Conjugate Vaccine (PCV-15) Compared to PCV-13 in Healthy Older Adults","volume":"15","author":"Stacey","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1093\/cid\/ciab990","article-title":"Pivotal Phase 3 Randomized Clinical Trial of the Safety, Tolerability, and Immunogenicity of 20-Valent Pneumococcal Conjugate Vaccine in Adults Aged \u226518 Years","volume":"75","author":"Essink","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e1489","DOI":"10.1093\/cid\/ciaa1045","article-title":"Safety, Tolerability, and Immunogenicity of a 20-Valent Pneumococcal Conjugate Vaccine (PCV20) in Adults 60 to 64 Years of Age","volume":"73","author":"Hurley","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1080\/21645515.2018.1533777","article-title":"Coadministration of 13-Valent Pneumococcal Conjugate and Quadrivalent Inactivated Influenza Vaccines in Adults Previously Immunized with Polysaccharide Pneumococcal Vaccine 23: A Randomized Clinical Trial","volume":"15","author":"Thompson","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/j.vaccine.2022.11.046","article-title":"Safety and Immunogenicity of a 20-Valent Pneumococcal Conjugate Vaccine Coadministered with Quadrivalent Influenza Vaccine: A Phase 3 Randomized Trial","volume":"41","author":"Cannon","year":"2023","journal-title":"Vaccine"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"4190","DOI":"10.1016\/j.vaccine.2023.05.002","article-title":"Randomized Trial to Evaluate the Safety, Tolerability, and Immunogenicity of a Booster (Third Dose) of BNT162b2 COVID-19 Vaccine Coadministered with 20-Valent Pneumococcal Conjugate Vaccine in Adults \u226565 Years Old","volume":"41","author":"Young","year":"2023","journal-title":"Vaccine"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"6321","DOI":"10.1016\/j.vaccine.2017.09.012","article-title":"Immunogenicity and Safety of an Inactivated Quadrivalent Influenza Vaccine Co-Administered with a 23-Valent Pneumococcal Polysaccharide Vaccine versus Separate Administration, in Adults \u226550years of Age: Results from a Phase III, Randomized, Non-Inferiority Trial","volume":"35","author":"Drame","year":"2017","journal-title":"Vaccine"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.2147\/IDR.S165093","article-title":"Overview of Pneumococcal Serotypes and Genotypes Causing Diseases in Patients with Chronic Obstructive Pulmonary Disease in a Spanish Hospital between 2013 and 2016","volume":"11","author":"Shoji","year":"2018","journal-title":"Infect. Drug Resist."},{"key":"ref_77","first-page":"1309746","article-title":"Airway Epithelium Dysfunction in Cystic Fibrosis and COPD","volume":"2018","author":"Molloy","year":"2018","journal-title":"Mediat. Inflamm."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"4720","DOI":"10.1128\/IAI.67.9.4720-4724.1999","article-title":"Pneumococcal Surface Protein A Inhibits Complement Activation by Streptococcus Pneumoniae","volume":"67","author":"Tu","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.1128\/IAI.69.5.3372-3381.2001","article-title":"Characterization of Binding of Human Lactoferrin to Pneumococcal Surface Protein A","volume":"69","author":"Roche","year":"2001","journal-title":"Infect. Immun."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1086\/317602","article-title":"Immunization of Humans with Recombinant Pneumococcal Surface Protein A (rPspA) Elicits Antibodies That Passively Protect Mice from Fatal Infection with Streptococcus Pneumoniae Bearing Heterologous PspA","volume":"182","author":"Briles","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Kono, M., Iyo, T., Murakami, D., Sakatani, H., Nanushaj, D., and Hotomi, M. (2023). Maternal Immunization with Pneumococcal Surface Protein A Provides the Immune Memories of Offspring against Pneumococcal Infection. Front. Cell Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1059603"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Akbari, E., Negahdari, B., Faraji, F., Behdani, M., Kazemi-Lomedasht, F., and Habibi-Anbouhi, M. (2019). Protective Responses of an Engineered PspA Recombinant Antigen against Streptococcus Pneumoniae. Biotechnol. Rep., 24.","DOI":"10.1016\/j.btre.2019.e00385"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e00264-18","DOI":"10.1128\/mBio.00264-18","article-title":"Antigenic Variation in Streptococcus Pneumoniae PspC Promotes Immune Escape in the Presence of Variant-Specific Immunity","volume":"9","author":"Georgieva","year":"2018","journal-title":"mBio"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"McNeela, E.A., Burke, A., Neill, D.R., Baxter, C., Fernandes, V.E., Ferreira, D., Smeaton, S., El-Rachkidy, R., McLoughlin, R.M., and Mori, A. (2010). Pneumolysin Activates the NLRP3 Inflammasome and Promotes Proinflammatory Cytokines Independently of TLR4. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1001191"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"4255","DOI":"10.1016\/j.vaccine.2018.05.122","article-title":"Immunogenicity and Mechanisms of Action of PnuBioVax, a Multi-Antigen Serotype-Independent Prophylactic Vaccine against Infection with Streptococcus Pneumoniae","volume":"36","author":"Hill","year":"2018","journal-title":"Vaccine"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"7181","DOI":"10.1016\/j.vaccine.2017.10.076","article-title":"Safety and Immunogenicity of a Novel Multiple Antigen Pneumococcal Vaccine in Adults: A Phase 1 Randomised Clinical Trial","volume":"35","author":"Entwisle","year":"2017","journal-title":"Vaccine"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"105325","DOI":"10.1016\/j.micpath.2021.105325","article-title":"Subcutaneous Immunization with the Fusion. Protein \u0394A146Ply-SP0148 Confers Protection against Streptococcus Pneumoniae Infection","volume":"162","author":"Wang","year":"2022","journal-title":"Microb. Pathog."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Dos Santos, T.W., Gon\u00e7alves, P.A., Rodriguez, D., Pereira, J.A., Martinez, C.A.R., Leite, L.C.C., Ferraz, L.F.C., Converso, T.R., and Darrieux, M. (2022). A Fusion Protein Comprising Pneumococcal Surface Protein A and a Pneumolysin Derivate Confers Protection in a Murine Model of Pneumococcal Pneumonia. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0277304"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Bersch, B., Bougault, C., Roux, L., Favier, A., Vernet, T., and Durmort, C. (2013). New Insights into Histidine Triad Proteins: Solution Structure of a Streptococcus Pneumoniae PhtD Domain and Zinc Transfer to AdcAII. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081168"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"3781","DOI":"10.1128\/IAI.00313-13","article-title":"CD4 T Cell Memory and Antibody Responses Directed against the Pneumococcal Histidine Triad Proteins PhtD and PhtE Following Nasopharyngeal Colonization and Immunization and Their Role in Protection against Pneumococcal Colonization in Mice","volume":"81","author":"Khan","year":"2013","journal-title":"Infect. Immun."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"7455","DOI":"10.1016\/j.vaccine.2012.10.080","article-title":"Safety and Immunogenicity of a Pneumococcal Histidine Triad Protein D Vaccine Candidate in Adults","volume":"30","author":"Seiberling","year":"2012","journal-title":"Vaccine"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.vaccine.2013.10.052","article-title":"Adjuvant System AS02V Enhances Humoral and Cellular Immune Responses to Pneumococcal Protein PhtD Vaccine in Healthy Young and Older Adults: Randomised, Controlled Trials","volume":"33","author":"Devaster","year":"2015","journal-title":"Vaccine"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"4610","DOI":"10.1016\/j.vaccine.2015.06.078","article-title":"PPR02 Study Team Safety and Immunogenicity of a Trivalent Recombinant PcpA, PhtD, and PlyD1 Pneumococcal Protein Vaccine in Adults, Toddlers, and Infants: A Phase I Randomized Controlled Study","volume":"33","author":"Brooks","year":"2015","journal-title":"Vaccine"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"6838","DOI":"10.1016\/j.vaccine.2014.02.052","article-title":"Safety, Reactogenicity and Immunogenicity of a Novel Pneumococcal Protein-Based Vaccine in Adults: A Phase I\/II Randomized Clinical Study","volume":"32","author":"Maes","year":"2014","journal-title":"Vaccine"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.vaccine.2018.11.015","article-title":"Immunization with Pneumococcal Elongation Factor Tu Enhances Serotype-Independent Protection against Streptococcus Pneumoniae Infection","volume":"37","author":"Nagai","year":"2019","journal-title":"Vaccine"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1043293","DOI":"10.3389\/fimmu.2022.1043293","article-title":"Construction and Protective Efficacy of a Novel Streptococcus Pneumoniae Fusion Protein Vaccine NanAT1-TufT1-PlyD4","volume":"13","author":"Cui","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1128\/CVI.00036-10","article-title":"Options for Inactivation, Adjuvant, and Route of Topical Administration of a Killed, Unencapsulated Pneumococcal Whole-Cell Vaccine","volume":"17","author":"Lu","year":"2010","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.3389\/fimmu.2019.01212","article-title":"Serotype-Independent Protection Against Invasive Pneumococcal Infections Conferred by Live Vaccine With Lgt Deletion","volume":"10","author":"Jang","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Rodrigues, T.C., Oliveira, M.L.S., Soares-Schanoski, A., Chavez-Rico, S.L., Figueiredo, D.B., Gon\u00e7alves, V.M., Ferreira, D.M., Kunda, N.K., Saleem, I.Y., and Miyaji, E.N. (2018). Mucosal Immunization with PspA (Pneumococcal Surface Protein A)-Adsorbed Nanoparticles Targeting the Lungs for Protection against Pneumococcal Infection. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191692"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1056\/NEJMoa012561","article-title":"New Strains of Bacteria and Exacerbations of Chronic Obstructive Pulmonary Disease","volume":"347","author":"Sethi","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1164\/rccm.200412-1747OC","article-title":"Moraxella Catarrhalis in Chronic Obstructive Pulmonary Disease: Burden of Disease and Immune Response","volume":"172","author":"Murphy","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1164\/rccm.200709-1413OC","article-title":"Pseudomonas Aeruginosa in Chronic Obstructive Pulmonary Disease","volume":"177","author":"Murphy","year":"2008","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/1040841X.2017.1329274","article-title":"Nontypeable Haemophilus Influenzae and Chronic Obstructive Pulmonary Disease: A Review for Clinicians","volume":"44","author":"Sriram","year":"2018","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1586\/14760584.2016.1156539","article-title":"Developing a Vaccine to Prevent Otitis Media Caused by Nontypeable Haemophilus Influenzae","volume":"15","author":"Khan","year":"2016","journal-title":"Expert. Rev. Vaccines"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1016\/j.vaccine.2016.04.051","article-title":"Phase I, Randomized, Observer-Blind, Placebo-Controlled Studies to Evaluate the Safety, Reactogenicity and Immunogenicity of an Investigational Non-Typeable Haemophilus Influenzae (NTHi) Protein Vaccine in Adults","volume":"34","author":"Haazen","year":"2016","journal-title":"Vaccine"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e00102-10","DOI":"10.1128\/mBio.00102-10","article-title":"Indirect Pathogenicity of Haemophilus Influenzae and Moraxella Catarrhalis in Polymicrobial Otitis Media Occurs via Interspecies Quorum Signaling","volume":"1","author":"Armbruster","year":"2010","journal-title":"mBio"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1086\/517611","article-title":"Haemophilus Influenzae Survival during Complement-Mediated Attacks Is Promoted by Moraxella Catarrhalis Outer Membrane Vesicles","volume":"195","author":"Tan","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"5551","DOI":"10.1016\/j.vaccine.2016.12.066","article-title":"Do We Need a Vaccine against Moraxella Catarrhalis in Chronic Lung Disease? What Are the Options and Opportunities?","volume":"37","author":"Perez","year":"2019","journal-title":"Vaccine"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"3113","DOI":"10.1016\/j.vaccine.2019.04.041","article-title":"Safety and Immunogenicity of Non-Typeable Haemophilus Influenzae-Moraxella Catarrhalis Vaccine","volume":"37","author":"Vandermeulen","year":"2019","journal-title":"Vaccine"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"6102","DOI":"10.1016\/j.vaccine.2019.07.100","article-title":"Non-Typeable Haemophilus Influenzae Protein Vaccine in Adults with COPD: A Phase 2 Clinical Trial","volume":"37","author":"Wilkinson","year":"2019","journal-title":"Vaccine"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S2213-2600(21)00502-6","article-title":"Non-Typeable Haemophilus Influenzae-Moraxella Catarrhalis Vaccine for the Prevention of Exacerbations in Chronic Obstructive Pulmonary Disease: A Multicentre, Randomised, Placebo-Controlled, Observer-Blinded, Proof-of-Concept, Phase 2b Trial","volume":"10","author":"Andreas","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1093\/cid\/cis627","article-title":"Pertussis in Older Adults: Prospective Study of Risk Factors and Morbidity","volume":"55","author":"Liu","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.arbres.2021.06.021","article-title":"Whooping Cough: The Visible Enemy","volume":"58","year":"2022","journal-title":"Arch. Bronconeumol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1080\/15412555.2021.1920904","article-title":"Seroprevalence of Bordetella Pertussis Infection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort","volume":"18","author":"Wilkinson","year":"2021","journal-title":"COPD"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1017\/S0950268817000887","article-title":"Economic Burden of Diagnosed Pertussis among Individuals with Asthma or Chronic Obstructive Pulmonary Disease in the USA: An Analysis of Administrative Claims","volume":"145","author":"Buck","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"77","DOI":"10.15585\/mmwr.mm6903a5","article-title":"Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2019","volume":"69","author":"Havers","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"100153","DOI":"10.1016\/j.opresp.2021.100153","article-title":"Pertussis Vaccine in COPD and Asthma: An Old Acquaintance Is Back","volume":"4","year":"2022","journal-title":"Open Respir. Arch."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/2\/213\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:01:41Z","timestamp":1760104901000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/2\/213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,18]]},"references-count":117,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["vaccines12020213"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12020213","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,18]]}}}