Polysaccharide pneumococcal vaccination has been designated a core quality measure despite the fact that it does not prevent pneumonia and from the standpoint of absolute risk reduction its effects on the complications of pneumococcal infection are modest.
This study, reported in the Archives of Internal Medicine, compared vaccinated and unvaccinated patients hospitalized with community acquired pneumonia and found a reduction in a composite outcome of death or admission to the ICU in vaccinated patients. Buried in the body of the paper is the statement that the entire effect was due to the reduction in ICU admissions. There was no effect on mortality.
So, when you administer pneumococcal vaccine to your patients at discharge you won’t prevent pneumonia and probably won’t help them live longer, but you’ll decrease the likelihood of admission to ICU next episode.
The polysaccharide pneumococcal vaccine, which is the only kind approved for adults, is a weak sister compared to the conjugate vaccine approved for kids. We need a conjugate vaccine for adults. Is anybody out there working on it?