We appreciate Dr Hirsch's thoughtful comments about our study and hope that his recent experience with influenza vaccination is reflected nationally. While pneumococcal vaccination prevalence has continued to increase in the United States, influenza vaccination levels for the population 65 years or older actually decreased in 2001 compared with 2000.1 We also hope that influenza vaccination rates for the Medicare population will increase following the distribution delays of the past 2 years. However, in the absence of widespread implementation of systems-based immunization strategies, we are not optimistic that this will translate into higher rates of inpatient vaccination against influenza and pneumococcal disease. When our findings are compared with a study of Medicare patients hospitalized with pneumonia in 1995, rates of vaccination in this setting have changed little since that time.2,3
Bratzler DW, Houck PM. Vaccination Rates: Supply, Demand, and Tracking—Reply. Arch Intern Med. 2003;163(7):849–850. doi:10.1001/archinte.163.7.849-a
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