A health plan intervention to improve pneumococcal vaccination in the elderly.

In 1998, the Hawaii Medical Service Association, headquartered in Honolulu, partnered with a pharmaceutical manufacturer to promote pneumococcal immunization of its 33,017 Medicare cost-contract members. They disseminated newsletter articles, magazine advertisements, letters, posters, and broadcast announcements; held injection clinics; and provided physicians reminder postcards with patient labels. Medicare claims indicated that immunization rose by 13.3% in 1997, 20.7% in 1998, and 42.3% in 2000, exceeding rates in a fee-for-service control group. Moreover, the rate of hospitalization for pneumococcal pneumonia dropped after 1998. The data suggest that multimodal promotion of pneumococcal vaccine will result in more extensive immunization and less frequent hospitalization.