While tuberculosis has been a threat to public health since the first half of the 19th century, it continues to be a public health priority that currently affects over 10 million people.
In fact, tuberculosis was responsible for 1.6 million deaths in 2021 alone. Furthermore, 13-96% of pulmonary tuberculosis patients suffer from post-tuberculosis lung disease, and while there are nearly 66 million tuberculosis survivors, almost half of them are still suffering from PTLD.
Though PTLD continues to be a global health concern, there is clinical research emerging suggesting potential success in the prevention and mitigation of post-tuberculosis lung disease using the following vaccines:
- Influenza
- Pneumococcal
- COVID-19
- Pertussis
- Diphtheria
- Tetanus
- Measles
- BCG
Follow along to learn what each of these vaccines do, who they can benefit, and why they are being studied to reduce the effects of PTLD.
Influenza
What it Does
Both inactive and live attenuated influenza vaccines activate the innate and adaptive immune systems.
Who it Can Benefit
The influenza vaccine has been shown to benefit immunocompromised patients who may be more vulnerable to influenza complications. These vulnerabilities put them at a much higher risk for morbidity and mortality
Why it is Recommended for PTLD Patients
The WHO has recommended the annual vaccination of patients with chronic upper respiratory conditions, including lung disease.
Pneumococcal
What it Does
There are two types of pneumococcal vaccines: Pneumococcal conjugate vaccines and pneumococcal polysaccharide vaccines. These immunizations fight against illnesses caused by streptococcus penumoniae bacteria, such as pneumonia and strep throat.
Who it Can Benefit
Clinical evidence suggests these vaccines can prevent community-acquired pneumonia in patients with chronic respiratory diseases.
Why it is Recommended for PTLD Patients
Patients with PTLD can face detrimental after effects of respiratory illnesses and are recommended by the CDC to be vaccinated.
COVID-19
What it Does
While the efficacy of this vaccine is still under review, it is marketed to protect the body from the SARS-CoV-2 virus.
Who it Can Benefit
Much like that of influenza, this vaccination can majorly benefit immunocompromised patients who are at a higher risk to suffer from SARS-CoV-2.
Why it is Recommended for PTLD Patients
Evidence has suggested that COPD patients and those with upper respiratory infections have more severe reactions to COVID-19, which include but are not limited to:
- Multiple biological mechanisms
- Micro-thrombosis
- Intrapulmonary shunting
- Secondary bacterial infection
Pertussis
What It Does
Prevents patients from suffering from whooping cough.
Who it Can Benefit
COPD patients can experience the exacerbation of their pulmonary disease symptoms if pertussis is contracted, leading to higher rates of hospitalization compared to patients without COPD. Additionally, contracting pertussis furthers susceptibility to other infections for COPD patients.
Why it is Recommended for PTLD Patients
Patients suffering from post-tuberculosis lung disease share several clinical and pathological characteristics with patients of chronic lung disease, such as:
- COPD
- Asthma
- Bronchiectasis
Diphtheria
What it Does
Diphtheria Toxoid-Based Vaccine is a purified formulation of inactivated diphtheria toxin, and is designed to induce immune response to produce antibodies against toxins.
Who it Can Benefit
Though diphtheria is controlled throughout most of the world, it is recommended that individuals living in areas of low endemicity should receive one dose every ten years after their first dose.
Why it is Recommended for PTLD Patients
Based on historical reports, within tuberculosis-diphtheria co-infections, the severity of both diseases increase when present together. Additionally, a severe infection of diphtheria can potentially “Re-awaken” a tuberculosis infection.
Tetanus
What it Does
The tetanus vaccination is a toxoid vaccine to protect against clostridium tetani bacteria.
Who it Can Benefit
Recent clinical studies have shown a possible association between the history of tetanus vaccination and the risk and severity of COVID-19.
More specifically, in a study conducted by the team of Monereo-Sanchez showed that individuals with a history of receiving a tetanus vaccine during the past ten years resulted in a lower risk of developing a severe case of COVID-19.
Why it is Recommended for PTLD Patients
The recent evidence of the tetanus vaccination showing a protective effect against respiratory disorders has gotten the attention of medical professionals, and while the effects this vaccine on tuberculosis and post-tuberculosis lung disease requires more clinical research, it is possible it is able to exert some beneficial effects on pulmonary obstructions.
Measles
What it Does
The measles vaccine protects the body against the effects of measles, mumps and rubella.
Who it Can Benefit
Recent studies have suggested that patients with histories of measle vaccinations are at a lower risk of COVID-19 infection and mortality, and may have a reduced burden of other diseases as well.
Why it is Recommended for PTLD Patients
Recent publications show that measles vaccination was associated with not only a reduced amount of cases and deaths, but also putting patients at a lower risk for:
- Mortality
- Diarrhea
- Lower respiratory infection
- Malaria
- Meningitis
- Tuberculosis
BCG
While the effects of the BCG immunization in tuberculosis prevention have been surveyed since the 1920s and have been observed to prevent tuberculosis, its role in reducing post-tuberculosis lung disease reinfection remains to be proven.
Altogether, it is extremely important to understand the role vaccination plays in the contribution to preventing post-tuberculosis lung disease complications and side effects. We have observed the considerable benefits reaped by immunizing PTLD patients using the available vaccines and boosters as primary immune response inducers.
Ultimately, since PTLD impacts the respiratory system as a chronic respiratory condition, vaccinating against known preventable respiratory infections could efficiently limit secondary infections and further complications of post-tuberculosis lung disease.
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