Primary prevention

Pneumonia prevention is focused on the pathogens that cause disease, through vaccination and by managing the risks associated with disease development. 

The main means of prevention are pneumococcal and influenza vaccination of at-risk people and smoking cessation.[1] [ Cochrane Clinical Answers logo ]

  1. Pneumococcal and influenza vaccination of at-risk individuals. Public Health England recommends:[61]

    • Pneumococcal vaccination

      • Adults aged 65 or over and at-risk groups aged 2 years or over: a single dose of 23-valent pneumococcal polysaccharide vaccine (PPV23). At-risk groups are those with:[62]

        • Asplenia or dysfunction of the spleen

        • Chronic respiratory, heart, kidney, or liver disease

        • Diabetes

        • Immunosuppression

        • Cochlear implants

        • Cerebrospinal fluid leaks

        • Occupational risk.

      • At-risk patients should be offered immunisation at every opportunity (for example, when immunising against influenza or at routine consultations), and especially at discharge from hospital.[62]

    • Influenza vaccination

      • Adults aged 65 or over, people aged 6 months or over who are in at-risk groups, and children aged 2 to 17 who are not in at-risk groups who are part of the phased vaccination roll-out in the UK: annual influenza vaccine with an age-appropriate formulation, provided they do not have a contraindication. At risk groups are pregnant women and those with:[63]

        • Chronic respiratory, heart, kidney, liver, or neurological disease

        • Diabetes

        • Immunosuppression

        • Asplenia or dysfunction of the spleen

        • Class III obesity (BMI ≥40).

    Further information on vaccines, vaccination procedures, special patient populations, and current vaccination schedules in the UK can be found in the ‘green book’[62][63] Public Health England: immunisation against infectious disease – the 'green book' external link opens in a new window and the latest Public Health England vaccination schedule.[61] Public Health England: complete routine immunisation schedule external link opens in a new window

    Vaccination schedules vary by location; consult local guidance for recommendations.

  2. Smoking cessation

    • Smoking cessation is important for all patients, but particularly for those at risk of pneumonia and influenza. Offer advice according to national smoking cessation guidelines.[1] National Institute for Health and Care Excellence: stop smoking interventions and services external link opens in a new window

      • Cigarette smoking, both active and passive, is a recognised independent risk factor for CAP.[1] 

Secondary prevention

For all patients with CAP who smoke, offer advice according to national smoking cessation guidelines. National Institute for Health and Care Excellence: stop smoking interventions and services external link opens in a new window Explain to patients how smoking impairs natural mechanisms for eliminating pathogens and debris.[1]

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