Inclusion | |
 1. Men and women 65 years of age or older | |
 2. Community-dwelling | |
 3. Normal range of reference laboratory for: complete blood count and differential, thyroid stimulating hormone, serum vitamin B12, folate, vitamin E, AST/SGOT and ALT/SGPT, albumin, fasting blood glucose, blood urea nitrogen and serum creatinine | |
 4. Negative serum tests for hepatitis B and hepatitis C | |
Exclusion | |
 1. History or clinically apparent immunologically mediated chronic conditions (e.g., rheumatoid arthritis, lupus erythematosus). No exclusion for stable chronic non-immunologically mediated conditions (e.g., osteoarthritis, well controlled hypertension) | |
 2. Immunodeficiency | |
 3. Severe respiratory disease requiring supplemental oxygen | |
 4. Psychiatric disorder, untreated or not in remission | |
 5. Infection within 2 weeks of immunization | |
 6. Inflammatory processes such as known chronic infections, inflammatory bowel disease or Westergren sedimentation rate (> 50 mm/hour for men, > 60 mm/hour for women) | |
 7. All malignancies (excluding non-melanotic skin cancer) and lymphoproliferative disorders diagnosed or treated actively during the past 5 years | |
 8. Arteriosclerotic event during the 2 weeks prior to enrollment (e.g., medically documented myocardial infarction, stroke, recanalization of the femoral arteries, claudication, or transient ischemic attack) | |
 9. Cardiac insufficiency, if heart failure present (New York Heart Association functional class III or IV) | |
 10. Poorly controlled hypertension (SBP ≥180 mmHg, DPB ≥100 mmHg) | |
 11. Renal Insufficiency (serum creatinine ≥2.0 or BUN ≥40) | |
 12. Elevated or low glucose (fasting ≥140 or < 70; non-fasting > 200) | |
 13. Cognitive impairment: score of < 23 on the Folstein Mini-Mental State Examination. | |
 14. Depression or mood alteration: score of ≥6 on the Geriatric Depression Scale | |
 15. Malnutrition as defined by clinical judgment and by decreased serum albumin (< 3.2 g/L) or hypocholesterolemia (< 160 mg/dL), or low total lymphocyte count (< 1500/ml3). | |
 16. Anemia (Hct < 30%) or low serum vitamin B12, folate, or vitamin E level | |
 17. History of or current alcoholism or consuming > 1 can of beer, 1 glass wine, or 1 oz. liqueur daily; current drug abuse; currently smoking ≥10 cigarettes per day. | |
 18. Risk factors for hepatitis B (such as parenteral drug abuse, multiple sexual partners, commercial sex worker, health care worker) | |
 19. History of hepatitis B infection or vaccination. | |
 20. Positive test for hepatitis B surface antigen or antibody, hepatitis B core antibody, or hepatitis C antibody. | |
 21. Unable to attend the Baltimore VA Medical Center on a regular basis; no telephone in primary residence. | |
 22. Subcutaneous fat pad less than 6 mm in thickness as determined by computer tomography | |
 23. Medication exclusions include prednisone > 5 mg/day (or equal), colchicine, methotrexate, azathioprine, cyclophosphamide, cyclosporine, or interferon. |