The emergency department as part of a successful strategy for increasing adult immunization.

To evaluate acceptance of the emergency department as a setting for vaccine delivery, we interviewed and offered pneumococcal vaccine to 338 high-risk ED patients presenting with unrelated complaints. Only 27 (8%) had previously been immunized with pneumococcal vaccine. Of the unimmunized, 187 (60%) initially indicated that they would accept vaccine during their current ED visit, and 51 (37%) of those without immediate medical contraindications were immunized. Willingness to take pneumococcal vaccine in the ED was independent of whether the patient had a primary medical provider (P = .77). Our immunization strategy complements other vaccination schemes that target those at high risk for pneumococcal disease and may in particular serve those patients who use the ED as their primary source of health care.