nearly significantP =0.076
34 In a randomized controlled trial in 596 COPD patients, PPV23 efficacy against CAP was significant at 76% (95% CI: 20–93, P =0.013) in patients <65 years of age, nearly significant at 48% (95% CI: 27–80, P =0.076) in those with severe airflow obstruction (<40% FEV 1 ), and strongest for both factors combined (91% [95% CI: 35–99, P =0.002]). 75 However, vaccine efficacy was not significant for the overall cohort (24% [95% CI: −24–54, P =0.333]).