Pneumococcal Vaccination: When in Doubt, Go Ahead-Reply

Abstract

In Reply. — It should be noted that our study did not call for universal pneumococcal vaccination of all persons. We studied a population of elderly Medicare enrollees. We suggested that immunization at the time of hospital discharge would be a useful strategy for ensuring that the majority of elderly persons otherwise destined to be hospitalized with pneumonia receive pneumococcal vaccine. The Immunization Practices Advisory Committee (ACIP) goes even further in its recommendation for universal pneumococcal vaccination for all persons aged 65 years or older, regardless of whether they have had a recent episode of hospital care. Dr Temianka is concerned about the possible increased risk of adverse reactions following inadvertent revaccination of patients who previously have received pneumococcal vaccine. In 1989, 1 the ACIP summarized all previously published reports and included the results of an unpublished randomized, controlled trial evaluating the risks of increased adverse reactions following revaccination with