vaccination is recommended for all individuals who do not have a contraindication. The Canadian Thoracic Society guidelines [56] suggest that individuals with COPD who are infected with influenza have a significant risk of requiring hospitalization. An AECOPD may be caused by bacterial infection and may be associated with increased volume and purulence of the sputum [59-63]. Yohannes and Hardy [71] suggest that studies of the efficacy of influenza vaccination on varying severities of COPD are lacking, however there is a 70% reduction in mortality from influenza following vaccination. Individuals who experience recurrent acute exacerbations who are vaccinated in the autumn will experience a reduced number of acute exacerbations over the winter months [56, 71-75]