Study Touts Lower Age for Pneumonia Shot

By JOANN LOVIGLIO : Associated Press Writer
Jun 17, 2003 : 3:01 pm ET

PHILADELPHIA -- Vaccinating everyone 50 or older against a bug that can cause pneumonia, meningitis or a blood infection would save lives and money, a new study suggests. Current guidelines call for vaccinating those 65 and up.

"Our calculations find it's something that's likely, particularly for those in high-risk groups, to improve health and save medical costs," said Jane E. Sisk, professor of health policy at Mount Sinai School of Medicine and lead author of the study in Tuesday's issue of Annals of Internal Medicine.

Sisk stressed that researchers were not recommending that the age be lowered, but that their goal was to provide data to the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. The committee's recommendations are usually adopted by the CDC, and most doctors generally follow CDC guidelines.

Each year in the United States, pneumococcal disease accounts for about 3,300 cases of meningitis, or infection in the brain and spinal cord; 60,000 cases of bacterimia, a blood infection; and 500,000 cases of pneumonia.

Current CDC recommendations say a one-time pneumococcal vaccine should be given to people 65 and older, or to people of any age with certain medical conditions that put them at higher risk for getting the disease -- including heart disease, diabetes and pulmonary disease.

An accompanying editorial from Dr. Pierce Gardner of the National Institutes of Health said that the study "provides strong impetus for lowering the recommended age for universal immunization with pneumococcal vaccine to 50 years of age."

Typically, some vaccines are recommended for everyone (like measles) and others (like flu) are recommended for those most likely to get a particular disease or get seriously ill if they contract it.

Using a computer model to simulate a "virtual" group of 50- to 64-year-olds, researchers applied a complex formula that compared the quality and length of life for people who were and who weren't vaccinated -- including medical costs, doctor's visits and hospitalization. The study focused on meningitis and bacterimia.

"The best summary of what this really means is that this is a good buy for health care," said Dr. Ben Schwartz, a member of the CDC committee's working group studying whether the age should be lowered.

However, he cautioned that because pneumococcal vaccination is recommended as a one-time-only shot, getting it at age 50 may make it less effective by the time someone reaches their 70s and 80s -- and are at greater risk of severe illness.

The study also found that blacks are two to five times more likely to contract pneumococcal-related illness than whites, but only half as likely as white people to be vaccinated.

"To me, that's one of the most important aspects of this research," Schwartz said. "We're looking at ways to improve rates of coverage within the African-American population."

The study was funded through a cooperative agreement from the CDC through the Association of Schools of Public Health.