Columbia University Medical Center

Pneumococcal Vaccination

Embargoed until Tuesday, October 21, at 4 p.m. EST.

Study Finds Pneumococcal Vaccination Cost-Saving for Elderly People New York, New York, October 21, 1997–Pneumococcal vaccination for elderly people both improves health and saves medical costs, according to an article in the October 22/29 Journal of the American Medical Association (JAMA). The per person cost of vaccination is more than offset by savings in hospital treatment of pneumococcal bacteremia, an infection in the blood, according to health economist Jane Sisk, Ph.D., professor of public health, Columbia University School of Public Health at Columbia-Presbyterian Medical Center.

Using data on disease patterns, vaccination effectiveness and safety, and Medicare payments, Sisk and her colleagues compared vaccination to no vaccination among people 65 years and older. Pneumococcal vaccination was found to improve health and reduce net medical costs for each of three elderly age groups in the United States: age 65 to 74, age 75 to 84, and age 85 and older. These findings also applied to three specific areas that differed in disease incidence and death–metropolitan Atlanta; Columbus (Franklin County), Ohio; and Rochester (Monroe County), New York, thus indicating the general applicability of the results. The cost-effectiveness analysis was limited to bacteremia and its treatment in hospitals, though the organism may also cause pneumonia and meningitis.

Pneumococcal Vaccine Study
“Vaccination of elderly people against pneumococcal bacteremia is one of the few interventions that have been found to both improve health and save medical costs,” said Sisk. For the 23 million unvaccinated elderly in 1993, vaccination against pneumococcal bacteremia would have gained about 78,000 years of healthy life and saved $194 million. The results lend economic support to recommendations by the Centers for Disease Control and Prevention that all people age 65 and older be vaccinated. Unlike annual recommendations for influenza vaccination, pneumococcal vaccination is usually recommended only once for elderly people. Pneumococcal vaccination is greatly underused, however. Though available since 1978, by 1995 only about 36 percent of elderly people had ever received pneumococcal vaccination, compared to 58 percent who received influenza vaccination in that year alone. The discrepancy between recommendations and current use is greatest for blacks. African-Americans have pneumococcal vaccination rates only about half those of whites (20 percent vs. 37 percent), but disease rates more than twice as high.

This underuse is especially striking in an era when policy is emphasizing improved health outcomes and cost containment. These cost-effectiveness results provide a compelling case for policymakers to work with health insurance plans, providers, and consumers to improve low vaccination coverage, which is wasting both lives and money, say the authors.

The only accredited school of public health in the New York metropolitan area and among the first in the nation, Columbia School of Public Health provides instruction and research opportunities to 650 graduate students in pursuit of masters and doctoral degrees. Its students and 150 multi-disciplinary faculty engage in research and service in the city, the nation, and around the world, while concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health and sociomedical sciences. –CSPH–