N. Fiebach et W. Beckett, PREVENTION OF RESPIRATORY-INFECTIONS IN ADULTS - INFLUENZA AND PNEUMOCOCCAL VACCINES, Archives of internal medicine, 154(22), 1994, pp. 2545-2557
Influenza and pneumococcal infections are important causes of hospital
ization and death among individuals who are elderly or who have chroni
c illnesses. Influenza and pneumococcal vaccines may prevent these inf
ections and their complications, but most high-risk patients have not
received them. Doubts about their effectiveness, fears of side effects
, and the lack of programs to promote their use contribute to the unde
ruse of these vaccines. Although adequate controlled trials in high-ri
sk patients are lacking, there is observational evidence that they are
moderately effective, reducing serious complications of influenza and
pneumococcal infections by about one-half. They are cost-effective co
mpared with other preventive interventions and may be cost saving. The
ir safety has been demonstrated in numerous studies. Health care provi
ders should promote influenza and pneumococcal vaccination. Strategies
that have been shown to be successful in increasing the use of these
vaccines include provider education and feedback, flagging charts of v
accination candidates, mailed reminders to patients without fall appoi
ntments, standing orders for nurses to administer the vaccines, walk-i
n vaccination clinics, and vaccination of hospitalized patients at dis
charge.