Pneumococcal Vaccine: To Use or Not
- David W. Fraser, MD;
- Claire V. Broome, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
The relicensure of pneumococcal vaccine in late 1977 capped an intensive investigation of the feasibility of vaccinating humans against pneumococcal disease. Austrian and Gold1 had shown the need for an effective vaccine by demonstrating that pneumococcal pneumonia could be fatal despite appropriate therapy, and Austrian and other co-workers2 showed that 14 serotypes cause three fourths of the cases of pneumococcal bacteremia, suggesting that a vaccine would be clinically useful if it included only those 14 of the 83 antigenically distinct capsular serotypes. The efficacy of polyvalent vaccines was shown in a series of trials with young gold miners in South Africa, who are at high risk of contracting pneumococcal pneumonia.2,3
Formulating rational recommendations for using 14-valent pneumococcal vaccine in the United States has proved to be a formidable task. Elsewhere in this issue (p 473), Patrick and Woolley have made a praiseworthy attempt at weighing the costs
