The utilization of pneumococcal polysaccharide vaccine among elderly Medicare beneficiaries, 1985 through 1988.

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.