If you could halve the mortality rate, would you do it?
If you could halve the mortality rate, would you do it?
复制标题
如果你可以将死亡率减半，你会这么做吗？
DOI：
10.1086/341404
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Poland,GregoryA
中科院分区：
文献类型：
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作者：
Poland,GregoryA
从每年的11月到3月，一种高传染性的生物制剂感染了数百万美国人，导致大约6500万人出现症状性疾病，3000万人寻求医疗护理，30万人住院治疗，25,000人死亡，其中绝大多数是老年人[1-3]。这种情况年复一年地重复，尽管有一种安全、有效的疫苗和安全、有效的抗病毒药物，能够预防和治疗感染。在美国，与这些年度流行病相关的年度成本为1120亿美元。读者可能会惊讶地发现，这种生物制剂是流感病毒。更令人惊讶的是，有证据表明，卫生保健工作者往往无法用可用的疫苗和抗病毒药来保护患者，尽管在此期间医疗保险覆盖了流感疫苗接种，但65岁人群的流感疫苗接种覆盖率从20%提高到60%花了近20年的时间。尽管自20世纪60年代以来，国家就建议在老年人口中普遍使用流感疫苗，但覆盖率仍然很低。美国公共卫生署制定了一个更高的目标：将65岁人群的流感和肺炎球菌疫苗接种率提高到90%。
From approximately November through March of each year, a highly transmissible biological agent infects millions of Americans, leading to an estimated 65 million persons who develop symptomatic illness, 30 million who seek medical care, 300,000 who are hospitalized, and 25,000 who die—the vast majority of whom are elderly [1–3]. This scenario is repeated year after year, despite the availability of a safe, effective vaccine and safe, effective antiviral drugs that are capable of both preventing and treating infection. The annual cost associated with these yearly epidemics in the United States is 1 $12 billion. Readers may at first be surprised to learn that this biological agent is the influenza virus. More surprising is the evidence that health care workers often fail to protect patients with the available vaccine and antiviral agents.It has taken almost 2 decades to move from a 20% influenza-vaccination coverage rate for persons aged 65 years to a 60% coverage rate, despite Medicare coverage of influenza vaccination during this period. This slow rate of coverage has occurred even though national recommendations have been in place for the universal use of influenza vaccine in the elderly population since the 1960s. An even higher goal has been set by the US Public Health Service: to increase influenza and pneumococcal vaccination rates among individuals aged 65 years to a 90% level.