A Cochrane review included 1 study with 167 subjects. The study compared 23-valent pneumococcal (PV) and influenza vaccine with influenza vaccine alone (control group) in adults with chronic lung disease (bronchiectasis and other diseases associated with bronchiectasis). A significant reduction in acute infective respiratory exacerbations in the PV group compared to the control group was found (OR 0.48, 95% CI 0.26 to 0.88; NNT 6, 95% CI 4 to 32) over 2-years. There was however no difference in episodes of pneumonia between groups and no data on pulmonary decline was available. In another study, a benefit in elimination of Strep. pneumoniae in the sputum was found in a non-randomised trial in children but no clinical effect was described.
Comment: The quality of evidence is downgraded by study quality (lack of blinding) and by imprecise results (few patients).