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Before I suggest something, I would be interested in knowing fewer information,
1. Which version of Reader, are you trying to install?
2. Are you trying to install on a fresh machine or already you have some version of Reader installed?
3. What is the the Service Pack version on your Vista OS ?
Well, I think you identified the problem.
My laptop shows no service pack at all. Period. So I tried to run Windows Update, but keep getting error code 8000FFFF, and after a bit of digging around on the web I've realized my laptop has an issue that won't be easily resolved. Thus, I'm just going to forget about it. I have Reader working on another (better) machine, so it's not a huge deal.
Anyway, I'm pretty sure this no fault to Adobe and that this stupid problem is caused by Windows Vista.
Thanks for the help.