I read with interest the study by Bratzler et al1 describing the low rate of vaccination of Medicare inpatients against influenza and pneumococcal disease during their study period. Several points about this issue deserve comment. First, this study analyzes hospitalizations in 1998. In my suburban general internal medicine practice, many elderly patients refused vaccinations despite my recommendations (and my cajoling), recalling adverse effects to vaccines they received many years past. That attitude seemed to change in the fall of 2000, when there was an influenza vaccine shortage. Suddenly even those patients who had been refusing vaccines requested an influenza vaccine, hoping to get something that was suddenly a valued commodity. These patients then realized that vaccines of the 21st century produce few adverse effects and are nearly painless. They then go on to become yearly recipients of influenza vaccines and finally agree to receive the pneumococcal vaccination. Therefore, it is my impression that a more timely study after the shortage would show improved rates of vaccination compared with this study.
Hirsch RL. Vaccination Rates: Supply, Demand, and Tracking. Arch Intern Med. 2003;163(7):849. doi:10.1001/archinte.163.7.849-a