Summary. The follow-up involved 201 adults with chronic obstructive pulmonary disease – COPD (100 were city dwellers and 101 were rural inhabitants). Of them, 100 patients were vaccinated against pneumococcal infection using the pneumococcal polysaccharide vaccine PPSV23, 101 patients were not vaccinated and formed the control group. We analyzed a rate and severity of COPD exacerbations 1 year before and after the vaccination. Vaccinated urban and rural residents with COPD demonstrated a 2.4-fold and a 2.5-fold decrease in the exacerbation rate, respectively. Among all vaccinated patients, 58 % of rural inhabitants and 25 % of city dwellers with COPD did not have COPD exacerbations during the year after the vaccination. The observed clinical effect demonstrated that PPSV23 can be used as one of tools to maintain the public health and to increase life expectancy.