The pneumococcal vaccine. Immunization at a crossroad
R. H. Pantell and T. J. Stewart
A new polyvalent pneumococcal vaccine (Pneumovax) was released in February
1978. In an effort to chronicle the dissemination of the vaccine to
high-risk patients, we prospectively followed up a single clinic population
and conducted a telephone survey of three neighborhood health centers, two
private practices, and a university hematology clinic. Three months after
notification of the vaccine arrival, physicians in the prospectively
chronicled clinic had immunized six of 12 patients with sickle cell
disease, five of 80 patients with chronic obstructive pulmonary disease,
three of 225 patients with diabetes, and three of 45 patients older than 80
years. Immunization policy in the other clinics surveyed varied greatly. As
an attempt to curb low-prevalence, high-severity illness in a small target
population, the pneumococcal vaccine presents a new set of problems in the
systematic implementation of an immunization.
