Missed opportunities for pneumococcal and influenza vaccination of Medicare pneumonia inpatients–12 western states, 1995

Invasive pneumococcal infection (i.e., bacteremia and meningitis) and influenza are important causes of morbidity and mortality among Medicare beneficiaries aged > or = 65 years. In the United States, the estimated annual incidence of pneumococcal bacteremia among persons aged > or = 65 years is 50-83 cases per 100,000 persons, and such infections are associated with a high case-fatality rate. Older persons account for >90% of influenza-related deaths, and Medicare costs for influenza-related hospitalizations can reach $1 billion each year. The Advisory Committee on Immunization Practices (ACIP) recommends that persons aged > or = 65 years receive at least one lifetime dose of pneumococcal vaccine and annual influenza vaccination and that hospitalization should be used as an opportunity to vaccinate. This report describes an assessment of the vaccination coverage of Medicare pneumonia patients who were admitted to hospitals in 12 western states from October 1994 through September 1995 (fiscal year 1995); the findings of this assessment indicate that the opportunity to provide pneumococcal vaccine was missed for up to 80% of those hospitalized at any time during the year, and the opportunity to provide influenza vaccine was missed for 65% of those who were admitted during October-December 1994.