A Need To Update and Revise the Pneumococcal Vaccine Recommendations for Adults

Our preoccupation with new microbial threats (severe acute respiratory syndrome, West Nile virus, and potential bioterrorism agents) has preempted attention from more familiar but still dangerous foes. Influenza and invasive pneumococcal disease, which together cause more than 30 000 deaths each year in the United States, remain the greatest public health challenge as measured by vaccine-preventable morbidity and mortality (1, 2).

Recommendations for the use of influenza and pneumococcal vaccines in adults are both age based (recognizing that disease incidence and mortality increase with age) and condition based (recognizing that certain underlying diseases or conditions increase the incidence or severity of influenza and invasive pneumococcal disease). There is a high degree of similarity in the list of high-risk conditions for which influenza vaccine is recommended and the list for which pneumococcal vaccine is recommended. As a result, recognition that an individual needs one vaccine should prompt consideration for the other vaccine to be given also.

In 2000, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommended that universal immunization of adults with influenza vaccine be initiated at 50 years of age (previously, the age for universal immunization for both influenza and pneumococcal vaccines was 65 years) on the basis of cost–benefit studies showing decreased disease, absenteeism, medical costs, and antibiotic use among vaccine …