Last winter, the Texas Department of Health called me aboutan outbreak of pneumococcal pneumonia at a nursing home. WhenI mentioned the outbreak to my daughter, a third-year medicalstudent, she asked, "How is that possible? Hadn't all the residentsof the nursing home been vaccinated?"
The elegant epidemiologic study of an outbreak of pneumococcaldisease by Nuorti et al. in this issue of the Journal1 forcesus to address the question of why some public health recommendationsthat are well known to medical students are so poorly implemented.In this outbreak, nearly one quarter of the residents of . . . [Full Text of this Article]
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