Is the CDC Right on Pneumococcal Vax Recs?

Last year, the CDC made a substantial change in its pneumococcal vaccine recommendations for older adults: rather than recommending a single dose of the pneumococcal polysaccharide 23 (PPSV23), they began recommending both the pneumococcal conjugate vaccine (PCV13) followed 12 months later by PPSV23. At first blush, the new recommendations struck us as complex, but they seemed logical. Who wouldn't support a new vaccine that could reduce the burden of a very serious condition among older adults? We were particularly compelled because PPSV23, although proven to be effective in younger patients, is less well tested in the elderly. But upon closer inspection, we began to have doubts about the wisdom of the new guidelines -- which we have outlined in detail in a viewpoint published this week inJAMA Internal Medicine. Our biggest concern is that the benefits that were demonstrated in the only randomized controlled trial of PCV13, called the CAPiTA trial are likely not applicable in the U.S. http://www.medpagetoday.com/Blogs/SlowMedicine/54307?xid=nl_mpt_DHE_2015-10-27&eun=g721819d0r