A 65-year-old woman was diagnosed with the following: chronic rheumatic heart disease, I degree of rheumatic activity; combined mitral heart disease with prevalence of III-degree stenosis; heart failure IIA with retained left ventricular ejection fraction, functional class III (NYHA). What tactics of vaccination against respiratory infections should be chosen to provide secondary prevention of exacerbations and to avoid heart failure decompensation in this patient?

Answer options

1. Any vaccination is contraindicated due to mitral valve disease
2. Scheduled yearly vaccination against influenza and pneumococci
3. Any vaccination is contraindicated due to elderly age of the patient
4. Vaccination is contraindicated due to severe heart failure
5. Vaccination should be combined with antibiotic administration

Explanation

For seasonal influenza vaccination WHO recommends, in addition to pregnant women, risk groups to be considered: children aged 6-59 months, elderly persons ≥ 65 years of age, individuals with specific chronic medical conditions, and health-care workers.In addition to the seasonal influenza vaccine, people 65 years and older should also get pneumococcal vaccines, which protect against pneumococcal disease. CDC recommended them for all adults over 65 years old and for adults younger than 65 years who have certain chronic health conditions: chronic heart disease (excluding hypertension), chronic lung disease, chronic liver disease, alcoholism, diabetes mellitus, cigarette smoking1. Summary of Who Position Papers – Recommendations or Routine Immunization (updated: August 2018) from