Hostname: page-component-77c89778f8-sh8wx Total loading time: 0 Render date: 2024-07-16T19:46:21.576Z Has data issue: false hasContentIssue false

Hospital-Based Pneumococcal Immunization: The Epidemiologic Rationale and Its Implementation

Published online by Cambridge University Press:  02 January 2015

David S. Fedson*
Affiliation:
Department of Medicine, The University of Chicago, Chicago, Illinois
*
Department of Medicine, The University of Chicago, 950 East 59th Street, Chicago, IL 60637

Abstract

Many patients hospitalized for or dying of pneumococcal bacteremia have been discharged from a hospital with in the previous five years. In addition to age and underlying medical condition, previous hospital care, particularly for high risk conditions, is a useful marker for identifying individuals who are destined to develop serious pneumococcal infections. Relatively few patients, especially those with high risk conditions, would need to receive pneumococcal vaccine at the time of hospital discharge to prevent, within the next five years, each subsequent readmission or death from pneumococcal pneumonia. Although pneumococcal vaccine has not been widely used in the hospital setting, there are sound epidemiologic reasons to expect that organized programs for vaccine delivery in hospitals would be an effective approach to preventing many serious pneumococcal infections.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Cockburn, WC: The importance of infections of the respiratory tract. J Infection 1(suppl):38, 1979.Google Scholar
2. Center for Disease Control, United States Immunization Survey: 1975. US Department of Health, Education, and Welfare, Public Health Service. HEW Publication No. (CDC) 76-8221, June, 1976.Google Scholar
3. Summary Report, Surgeon General's Meeting on Influenza, February 12, 1979. US Department of Health, Education and Welfare, Public Health Service. February 23, 1979.Google Scholar
4. Fedson, DS: Recent developments in immunization. Primary Care 6:169194, 1979.Google Scholar
5. Recommendation of the Immunization Practices Advisory Committee (ACIP). Pneumococcal polysaccharide vaccine. Morb Mort Weekly Rep 30:410419, 1981.Google Scholar
6. Recommendations of the Public Health Service Immunization Practices Advisory Committee. Influenza vaccine 1981-82. Morb Mort Weekly Rep 30:279288, 1981.Google Scholar
7. Center for Disease Control, United States Immunization Survey: 1978. US Department of Health, Education and Welfare, Public Health Service. DHEW Publication No. (CDC) 79-8211, July, 1979.Google Scholar
8. National Center for Health Statistics. Hospitalization in the last year of life – United States, 1961. IIS Department of Health, Education, and Welfare, Public Health Service, 1965: Series 22, number 1, table 2.Google Scholar
9. National Center for Health Statistics. Episodes and duration of hospitalization in the last year of life. United Stales, 1961. US Department of Health, Education, and Welfare, Public Health Service. 1965: Series 22, number 2, tables 6, 10.Google Scholar
10. Barker, WH, Mullooly, JP: Pneumonia and influenza deaths during epidemics: Implications for prevention. Arch Intern Med 142:8589. 1982.Google Scholar
11. Turk, DC: Frequencies of pneumococcal types causing infections in patients admitted to the Radcliffe Infirmary, Oxford 1969-77-7 Hyg (Camb) 81:227238, 1978.Google Scholar
12. Mufson, MA: Pneumococcal infections. JAMA 246:19421948, 1981.Google Scholar
13. Kavet, J: Vaccine utilization: Trends in the implementation of public policy in the USA, in Selby, P (ed): Influenza: Virus, Vaccines, Strategy. New York, Academic Press 1976, pp 297308.Google Scholar
14. O'Donoghue, JM, Ray, CG, Terry, DW Jr, et al: Prevention of nosocomial influenza with amantadine. Am J Epidemiol 97:276282, 1973.Google Scholar
15. Hilleman, MR, Carlson, AJ Jr, McLean, AA, et al: Streptococcus pneumoniae polysaccharide vaccine: Age and dose responses, safety, persistence of antibody, revaccination, and simultaneous administration of pneumococcal and influenza vaccines. Rev Infect Dis 3:S31S42, 1981.CrossRefGoogle ScholarPubMed
16. National Center for Health Statistics, Utilization of short stay hospitals: Annual summary for the United States, 1978. US Department of Health, Education, and Welfare, Public Health Service. DHEW Publication No. (PHS) 80-1797 Series 13, number 46, March, 1980, table 13.Google Scholar
17. National Center for Health Statistics, Current estimates from the National Health Survey: United States, 1978. US Department of Health, Education, and Welfare, Public Health Service. DHEW Publication No. (PHS) 80-1551, Series 10, number 130, November, 1979, table 15.Google Scholar
18. National Center for Health Statistics. Utilization of short stay hospitals by persons with alcohol-related diagnoses: United Stales, 1976. US Department of Health, Education, and Welfare, Public Health Service, DHEW Publication No. (PHS) 80-1791, Series 13, number 47 May, 1980, table 1.Google Scholar
19. National Center for Health Statistics. Health Resource Statistics, 1976-77 Edition. US Department of Health, Education, and Welfare, Public Health Service. DHEW Publication No. (PHS) 79-1509, 1979, tables 95, 206.Google Scholar
20. Bobula, JD: Design and methodology of the twelfth periodic survey of physicians, in Gaffney, JC, Blandon, L, (eds): Profile of Medical Practice 1979. Chicago, Ctr Health Serv Res Ad, AMA, 1979, tables 1, 17, pp 190, 204.Google Scholar
21. Office of the Assistant Secretary for Health, Health United States: 1978. US Department of Health, Education, and Welfare, Public Health Service. DHEW Publication No. (PHS) 78-1232, December, 1978, tables 81, 103.Google Scholar
22. Moss, JM: Pneumococcus infection in diabetes mellitus: Is this a justification for immunization? JAMA 243:23012303, 1980.Google Scholar
23. Fraser, DW, Broome, CV: Pneumococcal vaccine: To use or not. JAMA 245:498499, 1981.Google Scholar
24. Sabin, AB: Immunization: Evaluation of some currently available and prospective vaccines. JAMA 246:236241, 1981.Google Scholar
25. Hirschmann, JV, Lipsky, BA: Pneumococcal vaccine in the United States: A critical appraisal. JAMA 246:14281432, 1981.Google Scholar
26. Banta, HD, Behnev, CJ: Policy formulation and technology assessment. Milbank Mem Fund Quart 59:445479. 1981.Google Scholar
27. Willems, JS, Sanders, CR, Riddiough, MA, et al: Cost effectiveness of vaccination against pneumococcal pneumonia. New Engl J Med 303:553559, 1980.Google Scholar