Fargo health officials have denied that medical records were shared in a mailer sent to Cass County, North Dakota, suggesting that older adults may be eligible for certain vaccines. The ad, which included recommendations for pneumococcal pneumonia, shingles, respiratory syncytial virus, and tetanus/diphtheria/pertussis, also highlighted that even healthy adults aged 65 are at risk of missing adult shots recommended by the CDC (U.S. Centers for Disease Control and Prevention). The mailer sparked questions about whether vaccine records were used in creating a mailing list. Fargo Cass Public Health collected a list of names of people living in Cass County who were at least 50 years old through the North Dakota Immunization Information System. The agency did not share information with Pfizer, nor did access medical records to produce the list of recipients for the mailer. The recipient information was based on demographics of eligibility.