In 2000, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommended that universal immunization of adults with influenza vaccine be initiated at 50 years of age (previously, the age for universal immunization for both influenza and pneumococcal vaccines was 65 years) on the basis of cost–benefit studies showing decreased disease, absenteeism, medical costs, and antibiotic use among vaccine recipients 50 through 64 years of age (2). In this issue, Sisk and colleagues (3) provide strong impetus for also lowering the recommended age for universal immunization with pneumococcal vaccine to 50 years of age. First, using only the well-established vaccine benefit of protection against invasive pneumococcal disease (for example, bacteremia and meningitis) and conservative estimates of the duration of benefit (maximum, 6 years), Sisk and colleagues show that for the overall population age 50 through 64 years, the cost per added year of healthy life is well below that of well-established preventive measures, such as screening for colon cancer. Second, for individuals 50 through 64 years of age with high-risk conditions, pneumococcal vaccine actually saved medical costs and improved health. Third, cost–benefit analysis in both high- and low-risk groups showed greater benefit for African Americans. It has long been recognized that certain ethnic populations (for example, African Americans, Native Americans, and Alaska Natives) suffer rates of invasive pneumococcal disease 2 to 10 times greater than the general population and that the risk is manifest at an earlier age (1).