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March 25, 1983

Pneumococcal Vaccine for the `Healthy Elderly'?-Reply

Author Affiliations

Marshall University School of Medicine Huntington, WVa

JAMA. 1983;249(12):1567. doi:10.1001/jama.1983.03330360020023

In Reply.—  Since the incidence and case fatality rates of pneumococcal disease are high in persons 50 years of age or older (the elderly), they should receive pneumococcal polysaccharide vaccine.1,2 In our study of pneumococcal disease in Huntington, WVa, and environs, this age group had an annual incidence for total pneumococcal disease of 40 to 125 per 100,000.1 One in four elderly persons with bacteremic pneumococcal pneumonia died and four in five with extrapulmonary pneumococcal disease died. Other physicians have reported similar results.1Since most elderly persons have underlying diseases that place them at increased risk of serious pneumococcal disease, they usually constitute the largest group of persons tested in any study of pneumonia among adults. The data unequivocally support their being immunized with pneumococcal vaccine as a sound approach to preventing pneumococcal disease.3Persons 50 years of age or older who do not have overt