Since July 1981, Medicare has paid for the administration of pneumococcal vaccine without regard to the deductible limit and without copayment. Claims submitted to Medicare for reimbursement for the 4-year period from 1985 through 1988 for a 5% sample of elderly Medicare beneficiaries enrolled in part B who were not members of health maintenance organizations were analyzed. Vaccine was administered to an estimated 1 392 840 beneficiaries (5.34%). The total estimated cost to Medicare was $14.3 million, or approximately $10.27 per dose. Crude 4-year rates indicated that white persons were much more likely to be immunized than black persons (5.60% vs 2.94%). Persons 70 through 84 years of age had higher immunization rates than either younger or older beneficiaries. The number of immunizations given peaked in 1986 and declined thereafter. A variety of vaccination strategies that may raise the immunization level in the elderly have been developed. The broad implementation of successful strategies will be important if the goal of a 60% immunization level in the elderly by the year 2000 is to be reached.
(Arch Intern Med. 1991;151:2009-2016)