Immunization: How Not to Die Of Pneumonia

Every year 20,000 or more Americans over the age of 50 die of pneumococcal pneumonia. Yet medical men have known for more than a decade that there is a safe and effective one-shot vaccine to fight the disease. Why don’t doctors use the vaccine? Why don’t they urge their older patients to get a preventive shot? Philadelphia’s Dr. Robert Austrian asked the Association of American Physicians those questions last week, and the University of Pennsylvania professor promptly answered his own questions. Doctors, he said, have been so dazzled by penicillin that they rely on it even in cases where it is least effective.

Until the late 1930s, the only protection against pneumococcal pneumonia was serum prepared in animals. It was neither reliable nor safe. Then came the sulfas, and an intensified search for better medications for both prevention and treatment. Toward war’s end, the armed forces developed a vaccine from a fraction of the pneumococcus microbe itself. But six different types were needed. And by then, penicillin was becoming available. It was a great pneumococcus killer. Doctors ignored the vaccines.

This was all very well for younger patients: penicillin and their own powers of recovery would usually pull them through. But Dr. Austrian studied 529 pneumonia patients at Kings County Hospital in Brooklyn, and found that almost one-third of those over 50 died of their bloodstream infection. It seemed to have made no difference if they got penicillin.

The way to prevent 10,000 or more such needlessly early deaths each year, said Dr. Austrian, is for everyone over 50 to be immunized with six-way pneumococcus vaccine. One shot gives good immunity which lasts for years. But before the prescription can be filled, patients and their physicians will have to create a demand for the vaccine. No pharmaceutical house manufactures it today, because there is no market for it. Mass produced, it should cost no more than $1.50 a shot.