Background: Pneumonia is the third most frequent cause of hospitalization among Medicare beneficiaries in Washington State. While a vaccine against pneumococcal disease has been available since 1977, the 1999 Behavioral Risk Factor Surveillance System estimates that less than 60% of adults aged 65 years and older in Washington State have been vaccinated.
Methods: To assess the prevalence of pneumococcal vaccination policies, we surveyed all Washington nursing homes in 1999 and again in 2001 to assess changes during the intervening period.