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J Clin Med . Vaccination for Respiratory Infections in Patients with Heart Failure

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  • J Clin Med . Vaccination for Respiratory Infections in Patients with Heart Failure

    J Clin Med

    . 2021 Sep 22;10(19):4311.
    doi: 10.3390/jcm10194311.
    Vaccination for Respiratory Infections in Patients with Heart Failure

    Nicolas Girerd 1 , Nicolas Chapet 2 , Camille Roubille 3 , Jérôme Roncalli 4 , Muriel Salvat 5 , Frédéric Mouquet 6 , Nicolas Lamblin 7 , Jean-Pierre Gueffet 8 , Thibaud Damy 9 , Michel Galinier 10 , Jean-Michel Tartiere 11 , Cécile Janssen 12 , Emmanuelle Berthelot 13 , Sylvain Aguilhon 14 , Roger Escamilla 15 , François Roubille 16

    AffiliationsFree PMC article


    Bronchopulmonary infections are a major trigger of cardiac decompensation and are frequently associated with hospitalizations in patients with heart failure (HF). Adverse cardiac effects associated with respiratory infections, more specifically Streptococcus pneumoniae and influenza infections, are the consequence of inflammatory processes and thrombotic events. For both influenza and pneumococcal vaccinations, large multicenter randomized clinical trials are needed to evaluate their efficacy in preventing cardiovascular events, especially in HF patients. No study to date has evaluated the protective effect of the COVID-19 vaccine in patients with HF. Different guidelines recommend annual influenza vaccination for patients with established cardiovascular disease and also recommend pneumococcal vaccination in patients with HF. The Heart Failure group of the French Society of Cardiology recently strongly recommended vaccination against COVID-19 in HF patients. Nevertheless, the implementation of vaccination recommendations against respiratory infections in HF patients remains suboptimal. This suggests that a national health policy is needed to improve vaccination coverage, involving not only the general practitioner, but also other health providers, such as cardiologists, nurses, and pharmacists. This review first summarizes the pathophysiology of the interrelationships between inflammation, infection, and HF. Then, we describe the current clinical knowledge concerning the protective effect of vaccines against respiratory diseases (influenza, pneumococcal infection, and COVID-19) in patients with HF and finally we propose how vaccination coverage could be improved in these patients.

    Keywords: COVID-19 vaccine; heart failure; influenza vaccine; pneumococcal vaccine; respiratory infections; review article; vaccination coverage.