Vaccination recommendations in chronic lung disease

Clinical practice guidelines are systematically developed documents intended to assist health care professionals with decision-making processes in patient care. Our team has an interest in ensuring appropriate recommendations are covered in expert guidance for people living with chronic lung disease. Clinical practice guidelines will include advice and recommendations about specific treatments and interventions such as vaccinations. Such work is particularly important given the reported suboptimal adult vaccination coverage globally for routine vaccines and the prioritisation of adults with chronic lung disease for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. This project will act as strong foundation to incorporate vaccine information into clinical practice guidelines by outlining consistency of and differences in international guideline recommendations and identifying gaps in knowledge needed to inform new guideline documents. We will conduct a systematic review to synthesise the available national and international recommendations for vaccinations in the care of adults living with chronic lung disease. Specifically, we have the following objectives: • appraise the methodological quality of existing clinical practice guidelines for vaccinations in adults with chronic lung disease • explore the scope of clinical practice guidelines (i.e. what do they include in terms of adult vaccinations and are there any documented uncertainties/knowledge gaps) • determine the frequency of updates to clinical practice guidelines • compare clinical practice recommendations across diagnoses of chronic lung disease • examine the consistency of recommendations for vaccinations across clinical practice guidelines. We will search bibliographic databases, guideline repositories and respiratory society websites to identify guidelines that are intended to inform the management of asthma, non-cystic fibrosis bronchiectasis, COPD and/or interstitial lung diseases. The AGREE-II instrument will be used to assess the methodological quality of the included guidelines across six domains: scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability and editorial independence. No formal statistical analyses (meta-analysis) are planned for this review. Data (guideline recommendations or gaps/uncertainties) will be synthesised descriptively/narratively. Guideline recommendations will be presented within tables and graphs in the final report in the same order as the narrative text to facilitate interpretation of the findings. Similarities and differences in the number and level of practice recommendations will be structured according to type of lung disease and vaccine. Key gaps and/or uncertainties from the collated evidence will be tabulated and discussed narratively.