MMWR Morb Mortal Wkly Rep. 1997 Oct 3;46(39):919-23.
Invasive pneumococcal infection (i.e., bacteremia and meningitis) and influenza are important causes of morbidity and mortality among Medicare beneficiaries aged > or = 65 years. In the United States, the estimated annual incidence of pneumococcal bacteremia among persons aged > or = 65 years is 50-83 cases per 100,000 persons, and such infections are associated with a high case-fatality rate. Older persons account for >90% of influenza-related deaths, and Medicare costs for influenza-related hospitalizations can reach $1 billion each year. The Advisory Committee on Immunization Practices (ACIP) recommends that persons aged > or = 65 years receive at least one lifetime dose of pneumococcal vaccine and annual influenza vaccination and that hospitalization should be used as an opportunity to vaccinate. This report describes an assessment of the vaccination coverage of Medicare pneumonia patients who were admitted to hospitals in 12 western states from October 1994 through September 1995 (fiscal year 1995); the findings of this assessment indicate that the opportunity to provide pneumococcal vaccine was missed for up to 80% of those hospitalized at any time during the year, and the opportunity to provide influenza vaccine was missed for 65% of those who were admitted during October-December 1994.
侵袭性肺炎球菌感染（即菌血症和脑膜炎）以及流感是65岁及以上医疗保险受益人群发病和死亡的重要原因。在美国，65岁及以上人群肺炎球菌菌血症的估计年发病率为每10万人50 - 83例，且此类感染的病死率很高。老年人占流感相关死亡人数的90%以上，每年与流感相关住院治疗的医疗保险费用可达10亿美元。免疫实践咨询委员会（ACIP）建议，65岁及以上人群应至少接种一剂终身肺炎球菌疫苗并每年接种流感疫苗，且应利用住院机会进行疫苗接种。本报告描述了对1994年10月至1995年9月（1995财政年度）期间在12个西部州医院住院的医疗保险肺炎患者疫苗接种覆盖率的评估；该评估结果表明，一年中任何时候住院的患者中，高达80%的人错过了接种肺炎球菌疫苗的机会，在1994年10月至12月期间入院的患者中，65%的人错过了接种流感疫苗的机会。
