CDC Recommends Pneumococcal Vaccination For All Senior Citizens and Others at High Risk

Recommendations made during the 31st National Immunization Conference

Pneumococcal disease, including pneumonia, bacteremia and bacterial meningitis, is a serious health threat to Americans. Each year, it causes the deaths of approximately 40,000 Americans, most of them over 65 years of age. U.S. Public Health Service data suggest that nearly half of those deaths could be prevented if people 65 and older and others in high-risk groups were given pneumococcal vaccine.

CDC surveillance indicates that about 30 percent of people 65 and older have been immunized against pneumococcal disease. "This is far short of the 60 percent national goal set by the U.S. Public Health Service for the year 2000," said Robert Breiman, M.D., Director of CDC's National Vaccine Program Office. "Pneumococcal disease is the leading cause of what we call vaccine-preventable deaths, that is, deaths attributable to diseases for which vaccines are available."

In April, the CDC's Advisory Committee on Immunization Practices (ACIP) issued new and stronger recommendations for the use of pneumococcal vaccine, calling for vaccination of the following high-risk groups:

Persons aged 65 or older;

Persons aged 2-64 who have chronic illness such as chronic cardiovascular disease, chronic pulmonary disease (but not asthma), diabetes, alcoholism, chronic liver disease, or cerebrospinal fluid leaks;

Persons aged 2-64 who lack a functioning spleen (those with sickle cell disease or splenectomy);

Persons aged 2-64 who are living in special environments in which there is a higher risk for severe pneumococcal disease (Alaskan Natives, certain American Indian populations, residents of nursing homes and long-term care facilities);

Persons aged 2 or older with compromised immune systems including those with HIV.

The CDC has joined the Health Care Financing Administration (HCFA) and the National Coalition for Adult Immunization (NCAI) in a national, "Flu/Pneumo 2000 Campaign," to increase the number of Medicare beneficiaries receiving both pneumococcal and influenza vaccinations. Plans for the campaign were presented today to public health officials from across the United States attending the immunization conference.

Each year in the United States, pneumococcal disease, which is caused by the bacteria Streptococcus pneumoniae, accounts for an estimated 3,000 cases of meningitis (infection in the brain and spinal cord), 50,000 cases of bacteremia (infection in the blood), 500,000 cases of pneumonia, and seven million cases of otitis media (ear infections). Fatalities are highest among those with bacteremia and meningitis. Among elderly with pneumococcal bacteremia, the mortality rate is 30 to 40 percent.

"To make this situation worse, strains of antibiotic-resistant Streptococcus pneumoniae have become increasingly common in the United States and in other parts of the world," said Breiman. "That further emphasizes the need for preventing pneumococcal disease by vaccination."

Pneumococcal vaccinations generally need to be given only once. If there is uncertainty about earlier vaccinations, the vaccine should be administered to anyone 65 or older or anyone else in the high-risk groups. There are more than 33 million Americans who are 65 and older and more than 21 million Americans who fall into other high-risk groups.

Pneumococcal disease together with influenza and other vaccine-preventable diseases now cost society an estimated $10 billion each year. Approximately 90 percent of all costs associated with treating pneumococcal infections are for required hospital care. "Influenza and pneumococcal vaccination are cost-saving because the costs of vaccinating all elderly persons are less than the costs of providing medical care to those who develop influenza or pneumococcal disease," said Walter Williams, M.D., chief of CDC's Adult Immunization Branch.

More than 2,000 health care professionals, scientists and researchers are meeting this week during the 31st National Immunization Conference held here. Conference attendees are exploring the latest research and policy issues related to vaccine-preventable diseases and immunization for children and adults in the United States.

To speak to an information specialist or to receive information materials about pneumococcal vaccines and other vaccine-preventable diseases, contact CDC's National Immunization Information Hotline at 1 800 232-2522 (English) or 1 800 232-0233 (Spanish).

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES