Adult immunizations--a practical approach for clinicians: Part I.

Vaccine-preventable diseases cause needless sickness and death in adult Americans. Most adults 65 years of age or older have not been immunized against influenza or pneumococcal disease. In addition to an age of 65 years or older, indications for influenza and pneumococcal vaccines include chronic obstructive pulmonary disease, hemodynamically significant cardiac disease and infection with the human immunodeficiency virus. Many adults in the United States also are not sufficiently protected against tetanus, diphtheria, measles, mumps and rubella.