Association between COVID-19 vaccination and first healthcare utilization for chronic obstructive pulmonary disease: A nationwide population-based cohort study

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-06-06 DOI:10.1016/j.vaccine.2025.127367

Sang Hyuk Kim , Seung-Hun You , Ju Won Lee , Eunji Kim , Youlim Kim , Hyun Lee , Sun-Young Jung , Ji-Yong Moon

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引用次数: 0

Abstract

Background

Uncertainties about the impact of coronavirus disease 2019 (COVID-19) vaccination on chronic obstructive pulmonary disease (COPD) have been increasing. Thus, this study aimed to investigate the association between COVID-19 vaccination and COPD.

Methods

We conducted a cohort study using COVID-19 immunization registry data. The exposure was COVID-19 vaccination status, and the outcome was first healthcare utilization for COPD. Cox proportional hazards models were used to assess the risk of first healthcare utilization for COPD.

Results

Of the 27,595,469 individuals, 93.9 % had received COVID-19 vaccination. The risk of first healthcare utilization for COPD was significantly lower in vaccinated participants than in unvaccinated participants (hazard ratio [HR] = 0.46, 95 % confidence interval [CI] = 0.46–0.47). The decreased risk was more evident for first emergency room visits or hospitalizations for COPD (HR = 0.24, 95 % CI = 0.24–0.25). In the subgroup analysis, the decreased risk of first healthcare utilization for COPD was less significant in participants with frequent healthcare utilization, including the elderly, women, medical aid recipients, and those with comorbidities, than their counterparts. Of these, the smaller magnitude of the inverse association was observed in the pulmonary tuberculosis and asthma group. Regarding vaccination subtypes, the reduction was more prominent among those with a single vaccination (HR = 0.27, 95 % CI = 0.26–0.29) and mRNA recipients (HR = 0.35, 95 % CI = 0.35–0.36).

Conclusions

COVID-19 vaccination is associated with a decreased risk of first healthcare utilization for COPD, particularly concerning mRNA vaccine and emergency room visits or hospitalizations. Among frequent healthcare utilizers, the effect of vaccination is more pronounced in individuals with pulmonary tuberculosis or asthma than in those without pulmonary tuberculosis or asthma.

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COVID-19疫苗接种与慢性阻塞性肺疾病首次医疗保健利用之间的关系：一项基于全国人群的队列研究

关于2019冠状病毒病（COVID-19）疫苗接种对慢性阻塞性肺疾病（COPD）影响的不确定性一直在增加。因此，本研究旨在探讨COVID-19疫苗接种与COPD之间的关系。方法采用COVID-19免疫登记资料进行队列研究。暴露是COVID-19疫苗接种状况，结果是COPD的首次医疗保健利用。采用Cox比例风险模型评估COPD患者首次就诊的风险。结果27,595,469人中，93.9%的人接种了COVID-19疫苗。接种疫苗的受试者因COPD首次就医的风险显著低于未接种疫苗的受试者（风险比[HR] = 0.46, 95%可信区间[CI] = 0.46 - 0.47）。首次急诊室就诊或因COPD住院的患者风险降低更为明显（HR = 0.24, 95% CI = 0.24 - 0.25）。在亚组分析中，经常使用医疗服务的参与者（包括老年人、妇女、医疗援助接受者和那些有合并症的人）首次使用医疗服务的COPD风险降低的程度不如他们的同行显著。其中，在肺结核和哮喘组中观察到的负相关程度较小。就疫苗接种亚型而言，单次接种者（HR = 0.27, 95% CI = 0.26-0.29）和mRNA受体（HR = 0.35, 95% CI = 0.35 - 0.36）的降低更为显著。结论：covid -19疫苗接种与COPD首次医疗保健使用风险降低相关，特别是在mRNA疫苗和急诊室就诊或住院方面。在经常使用保健服务的人群中，接种疫苗的效果在肺结核或哮喘患者中比在没有肺结核或哮喘的人群中更为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.