News
ICViewExpert PerspectivesMedical World NewsPathogen PlaybookVideosWebinars
Conference CoverageConference ListingAPIC Chapters
Infection Control TodaySupplements And Featured Publications
CME/CEEditorial Advisory BoardJob BoardPartnersSponsoredWhitepapers
Subscribe
Educator of the Year Official Rules2024 Educator of the Year Winner2023 Educator of the Year WinnerEducator of the Year
Advanced TechnologyAdvanced TechnologyAdvanced Technology
Bug of the Month
COVID-19
Environmental ServicesEnvironmental Services
HAIs
Hand Hygiene
IC Trends
Long-Term CareLong-Term Care
Operating Room
Personal Protective EquipmentPersonal Protective Equipment
Policy
PreventionPreventionPreventionPrevention
Sterile ProcessingSterile Processing
Surface Disinfection
Vascular Access
Spotlight -
  • IC Trends
  • Bug of the Month
  • Featured Articles
  • Featured Columns
  • Pathogen Playbook
Advanced TechnologyAdvanced TechnologyAdvanced Technology
Bug of the Month
COVID-19
Environmental ServicesEnvironmental Services
HAIs
Hand Hygiene
IC Trends
Long-Term CareLong-Term Care
Operating Room
Personal Protective EquipmentPersonal Protective Equipment
Policy
PreventionPreventionPreventionPrevention
Sterile ProcessingSterile Processing
Surface Disinfection
Vascular Access
    • News
    • Subscribe
Advertisement

Recommending the Pneumococcal Vaccine at Age 50 Reduces Disease-Related Racial Disparities; But is it Cost-Effective?

March 4, 2019
Article

If mitigating racial disparities in those who contract pneumococcal diseases, such as meningitis and pneumonia, is a top public health priority, then recommending that all adults get a pneumococcal vaccine at age 50 would likely be effective guidance, according to a University of Pittsburgh School of Medicine analysis published today in the journal Vaccine. 

However, the Centers for Disease Control and Prevention does not make race-based vaccination recommendations, and, unless lowering the age for universal vaccination prompts double-digit increases in vaccination rates or the vaccine protects against more types of pneumonia than it has been proven to, it isn’t going to be cost-effective to change the current recommendation, the researchers found.

“It’s a nuanced issue, but nuanced vaccine recommendations typically don’t result in high immunization rates,” said senior author Kenneth J. Smith, MD, MS, professor of medicine and clinical and translational science in Pitt’s Division of General Internal Medicine. “Since there isn’t any major danger to getting the pneumococcal vaccine, a simple recommendation that everyone get it at age 50 is going to be easiest to implement. The main barrier then becomes cost.” 

There are two types of pneumococcal vaccine. Currently, the CDC recommends that all children under age 2 be immunized with pneumococcal conjugate vaccine (Prevnar 13®) in four doses spread out over slightly more than a year. All adults over age 65, all adult smokers and those with certain chronic medical conditions – including heart or lung disease, cancer, HIV/AIDS and diabetes – are urged to receive one dose of pneumococcal polysaccharide vaccine (Pneumovax23®), with those over 65 and the immunocompromised additionally advised to receive Prevnar 13®. 

Underserved minorities are considerably more likely to have the kinds of chronic medical conditions for which the CDC recommends they get pneumococcal vaccination before age 65. However, only 23 percent of people ages 50 to 64 with these chronic illnesses get the vaccination. 

“In a busy medical practice, it is easy for an early pneumococcal vaccination for someone with a chronic disease to fall through the cracks when you’re also dealing with the patient’s high blood pressure and other health issues,” said Smith. “That is why a simple age-based recommendation – where every patient at age 50 receives the vaccination – is much more likely to be adhered to.” 

Smith and his colleagues ran several computer models to forecast the effect of changing the pneumococcal vaccine recommendation to include all people at age 50. In all models, that recommendation would likely reduce the annual number of pneumococcal disease cases in the U.S. by several thousand and save a few hundred lives, disproportionately among minorities. 

To calculate the cost-effectiveness of lowering the age recommendation for pneumococcal vaccination, Smith’s team used the benchmark of $100,000 per quality-adjusted life-year. This is a measure that is generally accepted as representing reasonable value for health in the U.S. The current recommendation that all people receive pneumococcal vaccination at age 65 carries a $42,000 quality-adjusted life-year cost, which is under that benchmark. 

The researchers found that, if a simple recommendation that all people get the pneumococcal polysaccharide vaccine at age 50 drives vaccination rates in 50- to 64-year-olds up to 33 percent, from the current rate of 23 percent, then the cost would be $144,000 per quality-adjusted life-year in the general population, above the benchmark. But it would be $80,000 per quality-adjusted life-year in the black population, a reasonable value. 

“Vaccinating the general population against pneumococcal disease at age 50 doesn’t quite reach the U.S. benchmark for cost-effectiveness, but it’s not too far off,” Smith said. “It isn’t unreasonable to assume that vaccination rates will climb even higher than 33 percent – and each percent gained will improve the cost-effectiveness. If the priority is to mitigate racial disparities, then changing the recommendation to include all people at age 50 seems to be a good strategy. If controlling costs is key though, such a recommendation doesn’t quite meet the threshold.” 

This research was funded by National Institute for Allergy and Infectious Diseases grant R01 AI11657503. 

The article is “Cost-effectiveness of adult pneumococcal vaccination policies in underserved minorities aged 50-64 years compared to the US general population,” by Angela R. Wateska, M.P.H., et al (DOI: 10.1016/j.vaccine.2019.01.002). It appears in Vaccine, Volume 37, Issue 14 (2019), published by Elsevier.

Source: Health Sciences at the University of Pittsburgh

Recent Videos
Pathogen Playbook Presenter: Sharon Ward-Fore, BS, MS, MT(ASCP), CIC, FAPIC
Mark Wiencek, PhD
Rebecca Crapanzano-Sigafoos, DrPH, CIC, AL-CIP, FAPIC
The CDC’s updated hospital respiratory reporting requirement has added new layers of responsibility for infection preventionists. Karen Jones, MPH, RN, CIC, FAPIC, clinical program manager at Wolters Kluwer, breaks down what it means and how IPs can adapt.
Studying for the CIC using a digital tablet and computer (Adobe Stock 335828989 by NIKCOA)
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Cheron Rojo, BS, FCS, CHL,  CER, CFER, CRCST
Matthias Tschoerner, Dr Sc
Standardizing Cleaning and Disinfection
Related Content

Hot Topics With Saskia v. Popescu, PhD, MPH, MA, CIC, FAPIC

Hot Topics for IPC on July 2, 2025

Saskia v. Popescu, PhD, MPH, MA, CIC, FAPIC
July 2nd 2025
Article

This Hot Topics for IPC covers the latest on ASPR, AMR, vaccines, and a study on AMR and livestock manure from Michigan State University.


The Clean Bite

Personal Protective Equipment (PPE) for Dental Professionals: A Layered Defense

Sherrie Busby, EDDA, CDSO, CDIPC
July 1st 2025
Article

Dental infection control expert Sherrie Busby tackles PPE missteps, from chin-bra masks to cropped lab coats, reminding dental teams that proper protection is crucial, not optional.


Rebecca Battjes, MPH, CIC, FAPIC; Vidya Nankoosingh, MLT, CIC; and Peter Teska, MBA

Beyond the Surface: Rethinking Environmental Hygiene Validation at Exchange25

Tori Whitacre Martonicz
June 30th 2025
Article

Environmental hygiene is about more than just shiny surfaces. At Exchange25, infection prevention experts urged the field to look deeper, rethink blame, and validate cleaning efforts across the entire care environment, not just EVS tasks.


ACIP decides on vaccinations   (Adobe Stock 606491608 by N Lawrenson/peopleimages.com)

New ACIP Panel Backs Seasonal Flu, RSV Vaccinations, but Divisions Emerge Over Thimerosal and Infant Dosing

Richard Payerchin
June 27th 2025
Article

In its first major session under newly appointed leadership, the revamped Advisory Committee on Immunization Practices (ACIP) voted to support flu and RSV vaccinations for the 2025–2026 season, but internal debate over vaccine preservatives, access equity, and risk assessment highlighted the ideological and scientific tensions now shaping federal vaccine policy.


US Department of Health and Human Services

A Controversial Reboot: New Vaccine Panel Faces Scrutiny, Support, and Sharp Divides

Richard Payerchin
June 26th 2025
Article

As the newly appointed Advisory Committee on Immunization Practices (ACIP) met for the first time under sweeping changes by HHS Secretary Robert F. Kennedy Jr, the national spotlight turned to the panel’s legitimacy, vaccine guidance, and whether science or ideology would steer public health policy in a polarized era.


Jill Holdsworth, CIC, FAPIC, NREMT, CRCST, CHL; and Katie Belski, BSHCA, CRCST, CHL, CIS, CER, At HSPA25

Getting Down and Dirty With PPE: Presentations at HSPA by Jill Holdsworth and Katie Belski

Betsy Donahue, MA
June 26th 2025
Article

In the heart of the hospital, decontamination technicians tackle one of health care’s dirtiest—and most vital—jobs. At HSPA 2025, 6 packed workshops led by experts Jill Holdsworth and Katie Belski spotlighted the crucial, often-overlooked art of PPE removal. The message was clear: proper doffing saves lives, starting with your own.

Related Content

Hot Topics With Saskia v. Popescu, PhD, MPH, MA, CIC, FAPIC

Hot Topics for IPC on July 2, 2025

Saskia v. Popescu, PhD, MPH, MA, CIC, FAPIC
July 2nd 2025
Article

This Hot Topics for IPC covers the latest on ASPR, AMR, vaccines, and a study on AMR and livestock manure from Michigan State University.


The Clean Bite

Personal Protective Equipment (PPE) for Dental Professionals: A Layered Defense

Sherrie Busby, EDDA, CDSO, CDIPC
July 1st 2025
Article

Dental infection control expert Sherrie Busby tackles PPE missteps, from chin-bra masks to cropped lab coats, reminding dental teams that proper protection is crucial, not optional.


Rebecca Battjes, MPH, CIC, FAPIC; Vidya Nankoosingh, MLT, CIC; and Peter Teska, MBA

Beyond the Surface: Rethinking Environmental Hygiene Validation at Exchange25

Tori Whitacre Martonicz
June 30th 2025
Article

Environmental hygiene is about more than just shiny surfaces. At Exchange25, infection prevention experts urged the field to look deeper, rethink blame, and validate cleaning efforts across the entire care environment, not just EVS tasks.


ACIP decides on vaccinations   (Adobe Stock 606491608 by N Lawrenson/peopleimages.com)

New ACIP Panel Backs Seasonal Flu, RSV Vaccinations, but Divisions Emerge Over Thimerosal and Infant Dosing

Richard Payerchin
June 27th 2025
Article

In its first major session under newly appointed leadership, the revamped Advisory Committee on Immunization Practices (ACIP) voted to support flu and RSV vaccinations for the 2025–2026 season, but internal debate over vaccine preservatives, access equity, and risk assessment highlighted the ideological and scientific tensions now shaping federal vaccine policy.


US Department of Health and Human Services

A Controversial Reboot: New Vaccine Panel Faces Scrutiny, Support, and Sharp Divides

Richard Payerchin
June 26th 2025
Article

As the newly appointed Advisory Committee on Immunization Practices (ACIP) met for the first time under sweeping changes by HHS Secretary Robert F. Kennedy Jr, the national spotlight turned to the panel’s legitimacy, vaccine guidance, and whether science or ideology would steer public health policy in a polarized era.


Jill Holdsworth, CIC, FAPIC, NREMT, CRCST, CHL; and Katie Belski, BSHCA, CRCST, CHL, CIS, CER, At HSPA25

Getting Down and Dirty With PPE: Presentations at HSPA by Jill Holdsworth and Katie Belski

Betsy Donahue, MA
June 26th 2025
Article

In the heart of the hospital, decontamination technicians tackle one of health care’s dirtiest—and most vital—jobs. At HSPA 2025, 6 packed workshops led by experts Jill Holdsworth and Katie Belski spotlighted the crucial, often-overlooked art of PPE removal. The message was clear: proper doffing saves lives, starting with your own.

Advertise
About Us
Editorial Board
Contact Us
Job Board
Terms and Conditions
Privacy
Do Not Sell My Personal Information
Contact Info

2 Commerce Drive
Cranbury, NJ 08512

609-716-7777

© 2025 MJH Life Sciences

All rights reserved.
Home
About Us
News