Pneumococcal disease infects about 500,000 people each year in the U.S., killing about 25,000 of them. So, in 2010, when the FDA approved Pfizer s Prevnar 13, a vaccine that prevents pneumonia and other serious diseases caused by pneumococcus, for use in children between the ages of 6 weeks and 5 years, it represented a major advance in the prevention of infectious disease.
Those most adversely affected by pneumococcal pneumonia are typically aged 65 years and older. But amazingly, while the FDA approved the vaccine for use in all adults 50 and older way back in December, the CDC s Advisory Committee on Immunization Practices (ACIP) has yet to make the same recommendation. In fact, they won t even vote on it. Once ACIP makes this recommendation, Medicare must cover it, as will most private insurance. Until then, seniors who want the vaccine will have to pay for it out-of-pocket at a cost of over $100.
Pfizer, who makes the Prevnar 13 shot, is currently conducting a trial on more than 84,000 patients 65 and older to determine whether the vaccine is effective among this cohort. The folks at ACIP claim that they are waiting to approve the vaccine for wider use until the results of this large trial are in which may be next year. Or maybe not.
But ACSH s Dr. Josh Bloom doesn t buy this one bit. This vaccine is good enough for kids, and it s good enough for adults with compromised immune systems, so why, then, isn t it good enough for those over 50? he wonders. Although the committee says it is waiting for a the results of a very large trial in Europe, I don t believe it," he says. "They are simply stalling in order to save Medicare money upfront, without regard for the much larger savings that could be realized by preventing serious illnesses, hospitalizations, and death due to preventable infections. This is another case of short-term savings at long-term costs, and a possible peek into our future. If this isn t rationing, then what is?