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October 1983

Pneumococcal Vaccine in the Hospital: Improved Use and Implications for High-Risk Patients

Author Affiliations

From the Infection Control Unit (Dr Klein and Ms Adachi) and the Department of Medicine (Division of Infectious Diseases) (Dr Klein), North Central Bronx Hospital and Montefiore Medical Center, and the Department of Medicine, Albert Einstein College of Medicine (Dr Klein), Bronx, NY.

Arch Intern Med. 1983;143(10):1878-1881. doi:10.1001/archinte.1983.00350100040012

• A randomized trial of a program to improve pneumococcal immunization was undertaken. Also studied were the prevalence of high-risk conditions for serious pneumococcal disease among hospital admissions and prior hospitalization of patients with pneumococcal bacteremia. During two successive winters, 56% of 1,062 medical patients were identified by admission diagnosis or age as having a high-risk condition. None had received prior vaccination. During the trial period, identifying candidates for vaccination increased immunization from two (2.1%) of 95 to ten (10.4%) of 96 in year 1 and from two (2.1%) of 96 to 19 (20%) of 95 in year 2. Among adults with pneumococcal bacteremia, 33 (54%) of 61, including 32 (64%) of 50 with high-risk conditions, had documentation of prior hospitalization within five years. A hospital-based program can increase pneumococcal immunization rates and would be directed at patients in whom serious pneumococcal disease is likely to develop.

(Arch Intern Med 1983;143:1878-1881)

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