Pneumococcal pneumonia probably affects about one in every thousand adults each year. Like other serious pneumococcal infection, it is more common and severe in the elderly, in those without a functional spleen (including patients with sickle-cell disease,1) and in patients with a variety of chronic diseases. In the United States a 23-valent pneumococcal vaccine was introduced in 1983, replacing a 14-valent vaccine; it is now recommended there for large groups of people.2 This newer 23-valent vaccine (Pneumovax-II - MSD) was licensed in Britain last May. Its use should be considered for those at special risk of pneumococcal disease.3–5
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