First do no harm: ensuring that healthcare workers vaccinate and are vaccinated.

In the United States, influenza and pneumococcal diseases together are responsible for 20 to 50 times more deaths due to vaccine-preventable diseases than are all other vaccine-preventable diseases combined. During the 1990s, for example, it was estimated that more than 600,000 individuals died of influenza and pneumococcal diseases, whereas fewer than 15,000 deaths were reported for all other vaccine-preventable diseases. Vaccinations against influenza and pneumococcal diseases are safe and represent the most cost-effective means for preventing these diseases. Despite long-standing recommendations for their use, these vaccines are substantially underused in the elderly and other high-risk adult populations.