Abstract: The lack of benefit found by Åke Örtqvist and colleagues1Örtqvist Å Hedlund J Burman L-Å et al.Randomised trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and eldeerly people.Lancet. 1998; 351: 399-403Summary Full Text Full Text PDF PubMed Scopus (312) Google Scholar for the admission of 23-valent pneumococcal vaccine in middle-aged and elderly individuals reinforces the uncertainties that surround this intervention. The 1996 Report of the US Prevention Services Task Force2US Preventive Services Task ForceGuide to clinical preventative services. Williams & Wilkins, Baltimore1996Google Scholar listed pneumococcal vaccination in this population as only a B recommendation: “There is fair evidence to support the recommendation that the condition be specifically considered in a periodic health examination”.2US Preventive Services Task ForceGuide to clinical preventative services. Williams & Wilkins, Baltimore1996Google Scholar Even this level of endorsement seemed based on only one meta-analysis.3Fine MJ Efficacy of pneumococcal vaccination in adults: a meta-analysis of randomised controlled trials.Arch Intern Med. 1994; 154: 2666-2677Crossref PubMed Scopus (355) Google Scholar Furthermore, those groups at highest risk of infection (and with greatest need for effective prevention measures) are acknowledged, in the meta-analysis, to have no proven benefit from pneumococcal vaccination. Örtqvist and colleagues' finding of 50–80% effectiveness in the prevention of invasive pneumococcal disease is admirable. Given current evidence, however, an evangelical stance is inappropriate when we advise our immunocompetent middle-aged and elderly patients to submit to pneumococcal vaccination. In addition, the “strongly recommended” use of vaccination in high-risk groups, for whom no benefit has been proven, is puzzling.4US Department of health and Human Services, Public Health Service1997 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with HIV.Am Fam Physician. 1997; 56: 1131-1146PubMed Google Scholar Irrespective of its proven safety in these high-risk populations, one must question the value of such treatment. Effectiveness of pneumococcal vaccineAuthors' reply Full-Text PDF
Publication Year: 1998
Publication Date: 1998-04-01
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 7
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