To the Editor: The prospective cohort study by Dr Tseng and colleagues1 examined the association between pneumococcal vaccination and risk of acute myocardial infarction (MI) and stroke among 84 170 men aged 45 to 69 years from the California Men's Health Study followed up for a median of 5.3 years. The authors concluded that receipt of pneumococcal vaccine was not associated with subsequent reduced risk of acute MI and stroke. However, it is not clear whether the protective effect of pneumococcal vaccination against vascular events in individuals aged 65 years and older was properly assessed.
Kaczorowski J. Pneumococcal Vaccination and Cardiovascular Events in Men. JAMA. 2010;304(7):742-743. doi:10.1001/jama.2010.1145