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If pneumonia is the “old man's friend”, should it be prevented by vaccination? An ethical analysis

Authors
Journal
Vaccine
0264-410X
Publisher
Elsevier
Publication Date
Volume
23
Issue
29
Identifiers
DOI: 10.1016/j.vaccine.2005.01.158
Keywords
  • Pneumococcal Polysaccharide Vaccine
  • Adult Immunization
  • Pneumococcal Pneumonia
Disciplines
  • Medicine
  • Philosophy

Abstract

Abstract Because pneumococcal disease is a major problem among the elderly, pneumococcal polysaccharide vaccination is widely promoted. However, Sir William Osler called pneumonia the friend of the aged, leading to an ethical discussion. Mortality from pneumonia is higher with increasing degrees of underlying illness, outweighing the age effect. Although some symptoms are less common in the elderly, other symptoms are not and the duration may be longer. Problematic criteria for limiting pneumococcal polysaccharide vaccination include age, social value, and quality of life. Recommended criteria for limiting vaccination include autonomous patient refusal, imminent death, and lack of medical benefit, as would be seen in hospice cases.

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