Pneumococcal vaccination. Controversies and opportunities.

The morbidity and mortality associated with pneumococcal infections are preventable in many high-risk individuals by immunization with 23-valent pneumococcal vaccine. While the clinical effectiveness of the current vaccine is less than ideal, use of the vaccine is cost effective. In spite of recommendations for pneumococcal vaccination of elderly and other high-risk persons, and federal reimbursement for vaccination Medicare enrollees, it was estimated in 1985 that only 10% to 15% of this target population was immunized. Strategies for immunizing high-risk individuals with pneumococcal vaccine need to involve physicians, public health professionals, health advocacy groups, and persons in the targeted populations.