The pneumococcal vaccine. Immunization at a crossroad

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Abstract
A new polyvalent pneumococcal vaccine (Pneumovax) was released in Feb. 1978. To chronicle the dissemination of the vaccine to high-risk patients, a single clinic population was contacted via a telephone survey of 3 neighborhood health centers, 2 private practices and a university hematology clinic. Three mo. after notification of the vaccine arrival, physicians in the prospectively chronicled clinic immunized 6 of 12 patients with sickle cell disease, 5 of 80 patients with chronic obstructive pulmonary disease, 3 of 225 patients with diabetes and 3 of 45 patients older than 80 yr. Immunization policy in the other clinics surveyed varied greatly. To curb low-prevalence, high-severity illness in a small target population, the pneumococcal vaccine presents a new set of problems in the systematic implementation of an immunization.