Pneumonia is often relatively mild in healthy people, but it can be life-threatening for older adults, young children, and people whose immune systems are compromised by disease or medications. The good news is that there is an effective pneumonia vaccine available to fight it. In fact, according to the Centers for Disease Control and Prevention (CDC), the pneumonia vaccine is the best way you can protect yourself from the infection, which is a leading cause of death and hospitalization in older adults especially.
The pneumonia vaccine isn’t a guarantee that you won’t develop pneumonia, but it will significantly lower your risk. And even if you do get pneumonia, the vaccine can help ensure that your symptoms are mild.
Who Should Get the Pneumonia Vaccine?
With the dangers of pneumonia in mind, let’s consider who should get the pneumonia vaccine.
• Seniors. If you’re age 65 or older and haven’t had the pneumonia vaccine, discuss it with your doctor. As an older adult, you’re especially vulnerable to pneumonia because your natural immunity weakens with age. Your bronchial tubes contain tiny hair-like projections called cilia that help to sweep any bacteria out of your lungs. As you get older, cilia will weaken, making it easier for the bacteria that cause respiratory infections (including pneumonia) to slip through.
• People with weak immune systems. Heart disease, diabetes, and chronic obstructive pulmonary disease (COPD) weaken the immune system. Another reason why seniors are at greater risk for pneumonia is that they’re more likely to have these other conditions. If you have any of them, be sure to get the pneumonia vaccine. The same goes for people with HIV/AIDS, people who are receiving chemotherapy for cancer, people who have undergone an organ transplant, and people who have had their spleen removed.
• People who take certain medications. Chemotherapy drugs are red flags because they suppress the immune system in order to destroy cancer cells. Studies suggest that corticosteroids (which are used to treat COPD, asthma, and rheumatoid arthritis, among other conditions) and anticholinergic medications (used to treat asthma and incontinence) also may increase the risk for developing pneumonia. More recently, a study published in Annals of Internal Medicine (March 20, 2018) linked opioid drugs to a greater risk for pneumonia. The data didn’t show cause and effect, but the researchers say their findings should give pause to people who are at greater risk for pneumonia before taking opioids. The drugs have already been linked to a greater risk for addiction. Another newer study, this one published in Journal of the American Geriatrics Society (April 20, 2018), found that taking proton-pump inhibitors (PPIs). PPIs are used to treat gastroesophageal reflux disease, which is associated with a greater risk of pneumonia in people aged 60 and older who are taking these drugs on a long-term basis. PPIs also have been linked to increased rates for fractures and cardiovascular disease. If you do use these drugs, however, don’t stop taking them without first consulting your doctor.
• Hospitalized people. The elderly are at particular risk for hospital-acquired pneumonia, and so are people who spend time on a ventilator.
• Smokers. The chemicals in tobacco harm the immune system, and research suggests that smokers who develop pneumonia are more likely to be severely ill and need hospitalization. pneumonia-related mortality also is higher among smokers.
• Children. Before the pneumonia vaccine was developed, pneumococcal diseases, like pneumonia and meningitis, killed an average of 200 children age 5 and younger each year.
BACTERIAL OR VIRAL?
Bacterial pneumonia. The most common bacterium responsible for bacterial pneumonia is Streptococcus pneumoniae (also called pneumococcus). Older adults may develop bacterial pneumonia after having the flu or a cold, and it can be life-threatening.
Viral pneumonia. Viruses also can cause pneumonia, with influenza the most likely culprit. Older adults who have heart or lung disease, and/or take immunosuppressant drugs also are susceptible to viral pneumonia. Viral pneumonia is often milder than bacterial pneumonia, but it can also be serious, require treatment, and sometimes be fatal, especially in those who have a weakened immune system.
Two Pneumonia Vaccine Options
Prevention remains the main line of defense against pneumonia, so if you’re an older adult and you haven’t been vaccinated against the infection, discuss your options with your doctor.
A newer pneumonia vaccine (Prevnar 13) offers protection against 13 subtypes of the bacteria Streptococcus pneumoniae (see box), while an older vaccine, Pneumovax 23, protects against 23 additional subtypes. All people age 65 and older should receive both of these vaccines, but they can’t be given at the same time.
If you’ve never had either vaccine, Prevnar 13 is usually given first, and Pneumovax 23 is given one year later. If you’ve previously had Pneumovax 23, you can get the newer vaccine, too, as long as it has been at least a year since you had the other vaccine.
Infants and young children also should get Prevnar13 (you can see the CDC’s childhood immunization schedule by clicking here). Children who are at increased risk of pneumonia for any reason should also get the Pneumovax 23 vaccine at age 2 and older.
Experts also recommend an annual flu shot, because pneumonia often develops from flu.