Flu vaccine study aims to uncover why some COPD patients suffer more flare-ups

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: In order to be eligible to participate in this study, an individual in the COPD group must meet all of the following criteria: * Age\>40 years old * Physician diagnosis of COPD confirmed by post-bronchodilator testing (defined as forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)\< lower limit of normal and FEV1/FVC\<0.70) and FEV1\>30% predicted based on spirometry testing available in the prior year or completed at screening (if no historical testing available) * Free of acute exacerbation of COPD for prior four weeks at time of recruitment * Resting oxygen saturation \>94 percent * Blood pressure systolic values between 90-160 mm Hg and diastolic between 55-90 mm Hg * No nasal symptoms based on questionnaire * Willingness and ability to participate in study procedures * Completion of informed consent In order to be eligible to participate in this study, an individual in the healthy control group must meet all of the following criteria: * Age\>40 years old * Spirometry testing showing normal lung function (defined as pre and post--bronchodilator FEV1/FVC\>=lower limit of normal and FEV1\>80 percent predicted) based on spirometry testing available in the prior year or completed at screening (if no historical testing available) * Resting oxygen saturation \>94 percent * Blood pressure systolic values between 90-160 mm Hg and diastolic between 55-90 mm Hg * No nasal symptoms based on questionnaire * Willingness and ability to participate in study procedures * Completion of informed consent Exclusion Criteria: * Inability or unwillingness to consent * Active tobacco or e-cigarette use (within last six months) * Active diagnosis of asthma * Any regular suppressive antibiotics (i.e., azithromycin) * Daily oral prednisone use * Any supplemental oxygen use beyond nocturnal oxygen therapy * Use of intranasal corticosteroids in the 30 days prior to screening visit * Chronic illness associated with immunosuppression (i.e., HIV, malignancy) * History of documented or self-reported positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection requiring hospitalization * Receipt of SARS-CoV-2 vaccine within 14 days prior to study screening visit or plan to receive SARS-CoV-2 vaccine from screening visit to 14 days after completion of all study procedures * History of epistaxis, prior nasal surgery or anatomical abnormalities * Current use of blood thinner beyond full dose aspirin \[e.g., warfarin (coumadin), clopidogrel (Plavix), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis)\] * Self-reported history of easy bruising or bleeding gums * Serological evidence of HIV infection at screening (Positive HIV antibody test) * Relative leukopenia (WBC\<4000), neutropenia (Absolute neutrophil count\<2000) or lymphopenia (absolute lymphocyte count\<1500) on screening CBC * Respiratory infection (cough, sore throat, sinusitis, fever) within prior 4 weeks * Active wheezing at day 0 visit * Pregnancy or nursing or women who are currently trying to become pregnant. (All female subjects, except those who have had a hysterectomy with oophorectomy, will undergo urine pregnancy testing on the morning of the screening visit and again on the on Day 0 at the time of arrival to the lab and prior to LAIV administration. A positive pregnancy test will exclude the subject) * Use of chronic immunosuppression in the 30 days prior to screening visit * History of hypersensitivity, especially anaphylactic reactions, to egg proteins, gentamicin, gelatin, or arginine, or with a reaction to previous influenza vaccination at a severity level precluding the subject's participation as judged by the study physician * History of Guillain-Barre syndrome * Subjects who will be unable to avoid contact with immunocompromised individuals for 3 weeks after receiving LAIV vaccine * Receipt of the LAIV during the current or prior flu vaccine season * Physician diagnosed influenza, a positive test for influenza or suspicion of influenza illness in the 18 months prior to enrollment. Suspicion of influenza will be based on the CDC's influenza-like illness case definition ("fever\>100 °F AND cough/sore throat in the absence of a known cause other than influenza. Temperature can be measured in the office or at the home") * Any condition that, in the opinion of the study investigator, would compromise the subject's ability to participate in the study