Figure 2.

Complex interactions between asthma, asthma therapeutics, and vaccination. Corticosteroids are commonly used for asthma symptom control/prevention, but they alter the airway microbiome. Biologic therapy approved for asthma targets T2 immune response, but their effect during respiratory infections remains unclear. Antivirals may be useful for some asthma patients. Antibiotics cause alterations in the microbiome, are implicated in asthma development and severity, and cause impaired immune responses during viral and bacterial respiratory infections. Influenza vaccine is recommended for patients with asthma, although the usefulness of pneumococcal vaccination is controversial.