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October 21, 1974

Prospectus: The Prevention of Bacteremic Pneumococcal Pneumonia: A Conservative Appraisal of Vaccine Intervention

Author Affiliations

From the George Hunter Laboratory, Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn. Dr. Kaiser was a Clinical Associate of the Veterans Administration and is now Head of Infectious Diseases, St. Thomas Hospital, Nashville.

JAMA. 1974;230(3):404-408. doi:10.1001/jama.1974.03240030022019

Blood, cerebrospinal fluid, and respiratory isolates from 632 adults with pneumococcal pneumonia hospitalized from 1968 through 1972 were typed. The results were correlated with the 14 types currently being tested in pneumococcal vaccines. More than 80% of the bacteremic pneumonia isolates and two thirds of respiratory isolates were "vaccine types." Sixty percent of 43 patients with bacteremic pneumonia and 55% of patients who died from their infections would theoretically have benefited from an immunization program designed to include all persons 50 years of age and older and all younger patients with recognized underlying disease.

Unexplained swings in the annual rate of pneumococcal infections, siteto-site variation in the recovery of pneumococcal types, geographic and temporal differences in the distribution of types, and the selection pressure associated with the use of a limited number of vaccine types will complicate vaccine use.

(JAMA 230:404-408, 1974)