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Revaccination of High-Risk Adults With Pneumococcal Polysaccharide Vaccine
Kristin L. Nichol, MD, MPH
JAMA. 1999;281:280-281.
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Pneumococcal disease accounts for approximately 500,000 cases of pneumonia, 50,000 cases of bacteremia, and 40,000 deaths each year.1 Vaccination of adults with the pneumococcal polysaccharide vaccine has not been convincingly demonstrated to reduce the risk for pneumonia among groups currently targeted for vaccination2 but is associated with substantial reductions in invasive disease.1 Among the elderly, vaccination is not only cost-effective but cost saving for the prevention of bacteremia.3 Few other diagnostic or therapeutic interventions can make such a claim.
Initial vaccination induces a serotype-specific antibody response that is not associated with significant T-cell activation or immune memory. Antibody levels may decline over 5 to 10 years to prevaccination levels among immunocompromised persons and the elderly, which suggests that protection may wane over time.1 In a large case-control study, Shapiro et al4 found decreasing estimates of protection with increasing intervals after vaccination among the elderly. Following . . . [Full Text of this Article]
Author Affiliations: Minneapolis Veterans Affairs Medical Center and University of Minnesota, Minneapolis.
RELATED ARTICLE
Safety of Revaccination With Pneumococcal Polysaccharide Vaccine
Lisa A. Jackson, Patti Benson, Vishnu-Priya Sneller, Jay C. Butler, Robert S. Thompson, Robert T. Chen, Linda S. Lewis, George Carlone, Frank DeStefano, Patricia Holder, Tamar Lezhava, and Walter W. Williams
JAMA. 1999;281(3):243-248.
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