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March 25, 1983

Pneumococcal Vaccine for the `Healthy Elderly'?

Author Affiliations

State of New Mexico Health Services Division Santa Fe

JAMA. 1983;249(12):1566-1567. doi:10.1001/jama.1983.03330360020022

To the Editor.—  Vaccine manufacturers' recommendations for pneumococcal vaccine use differ in one extremely important respect from recommendations by the Centers for Disease Control1 and the American College of Physicians.2 At issue is whether healthy persons 50 years of age and older (the "healthy elderly") should routinely be given pneumococcal vaccine.A rational argument for routine pneumococcal vaccine use in this group requires, among other considerations such as vaccine safety and efficacy, knowledge of the incidence of pneumococcal pneumonia in the healthy elderly of this country. Unfortunately, the literature provides two surprisingly different incidence estimates for the general US population. At one extreme lie rates of two to five cases of pneumococcal pneumonia per 1,000 persons each year,3 while rates up to 25 times lower (20 to 45 cases per 100,000 persons per year)3-5 are also cited.Until studies in the healthy elderly accurately define the