[Prevention of pneumococcal infection by vaccination].

Background and objective: Infections with pneumococcus have a high morbidity and mortality rate. The elderly and patients with an immunodeficiency are at particular risk. The increasing resistance of Streptococcus pneumoniae to antibiotics impairs effective treatment. Prophylactic vaccination is possible since 1977. The currently available 23-valent polysaccharide vaccine is effective against more than 90% of the most common pneumococcal serotypes. Although the STIKO (Ständige Impfkommission am Robert-Koch-Institut, Berlin) has been recommending vaccination for the elderly and at risk patients since 1995, only 6% of the elderly are vaccinated.

Patients and methods: In 1999 in a prospective observational study involving 4347 vaccinations, in addition to demographic and anamnestic data, the tolerability of Pneumovax 23 was documented by the physician on the basis of a score (very good/good/moderate/ poor). Adverse events (AE) were recorded on the questionnaire of the Paul Ehrlich Institute. 83.5% of the patients were older than 60 years and 44% had at least one additional chronic disease. Influenza vaccinationwas given simultaneously in 23%.

Results: In 95.9% of the 4271 evaluable patients local, and in 97.3% systemic tolerability was assessed to be very good/good. Only in 1.4% (n = 60) of the patients were local and/or systemic adverse events seen.

Conclusion: Pneumococcal vaccination--also in combination with influenza vaccine, is safe and cost-effective.