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This refers to a combined vaccination intervention consisting of a seasonal influenza vaccine and a 23-valent pneumococcal polysaccharide vaccine (PPSV23). It was evaluated by Shanghai Zhongshan Hospital in the PAEAN (Probiotics, Amikacin, or Vaccination for COPD Exacerbation) trial for its efficacy in preventing acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in patients with moderate to very severe COPD. The rationale is that viral and bacterial infections are primary triggers for COPD exacerbations; by providing immunity against influenza viruses and *Streptococcus pneumoniae*, the intervention aims to reduce the frequency and severity of these events. In the study, the vaccines were administered at different body sites with a 3-5 day interval to minimize overlapping adverse events. Results indicated that dual vaccination significantly delayed the time to the first moderate-to-severe acute exacerbation compared to conventional treatment alone.
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