Community-acquired pneumonia (non Covid-19)

Pneumonia prevention is focused on the pathogens that cause disease, through specific vaccination or by managing the risks associated with disease development. The main means of prevention are influenza and pneumococcal vaccination and management of smoking cessation. [ ] Is there randomized controlled trial evidence to support the use of vaccines for preventing pneumococcal infection in adults?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.388/fullShow me the answer

Advisory Committee on Immunization Practices (ACIP) vaccination recommendations:[66]Centers for Disease Control and Prevention. Immunization schedules: adult immunization schedule by age: recommendations for ages 19 years or older, United States, 2024. Feb 2024 [internet publication]. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html [67]Centers for Disease Control and Prevention. Morbidity and mortality weekly report: pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023​. Sep 2023 [internet publication]. https://www.cdc.gov/mmwr/volumes/72/rr/rr7203a1.htm

• Adults who are immunocompetent and aged 65 years or older, who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown, should receive one dose of the 15-valent pneumococcal conjugate vaccine (PCV15) or one dose of the 20-valent pneumococcal conjugate vaccine (PCV20). If PCV15 is used, this should be followed by a dose of 23-valent pneumococcal polysaccharide vaccine (PPSV23) given at least 1 year after the PCV15 dose. Adults aged 19-64 years with specific comorbidities, immunocompromising conditions, cerebrospinal fluid (CSF) leak, or a cochlear implant should also be vaccinated according to this schedule. Adults who, at any age, have received PCV7 only (no longer manufactured) should also follow these recommendations.[67]Centers for Disease Control and Prevention. Morbidity and mortality weekly report: pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023​. Sep 2023 [internet publication]. https://www.cdc.gov/mmwr/volumes/72/rr/rr7203a1.htm

• In June 2019 ACIP voted to no longer routinely recommend PCV13, a 13-valent pneumococcal conjugate vaccine, for all adults ages ≥65 years and now recommends that adults ages ≥65 years who previously have received PCV13 only should complete their pneumococcal vaccine series by receiving either a single dose of PCV20 at an interval of ≥1 year after the PCV13 dose, or ≥ one dose of PPSV23 to complete their pneumococcal series. When PPSV23 is used, the minimum recommended interval between PS13 and PPSV23 is ≥8 weeks for adults with an immunocompromising condition, a CSF leak, or a cochlear implant, or ≥1 year for adults without these conditions.[67]Centers for Disease Control and Prevention. Morbidity and mortality weekly report: pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023​. Sep 2023 [internet publication]. https://www.cdc.gov/mmwr/volumes/72/rr/rr7203a1.htm ​ Adults with an immunocompromising condition, CSF leak, or cochlear implant who have received both PCV13 and PPSV23 but with incomplete vaccination status are recommended to complete their pneumococcal vaccine series with either a single dose of PCV20 at least 5 years after the last pneumococcal vaccine or with ≥ one dose of PPSV23. Full details of the timings and schedules for these are outlined in the latest ACIP recommendations.[67]Centers for Disease Control and Prevention. Morbidity and mortality weekly report: pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023​. Sep 2023 [internet publication]. https://www.cdc.gov/mmwr/volumes/72/rr/rr7203a1.htm

• Adults aged 19 years and older should receive an annual influenza vaccination with an age-appropriate formulation, provided they do not have a contraindication.

• Further details on current vaccination schedules and special patient populations can be found in the latest ACIP vaccination schedule. CDC: Advisory Committee on Immunization Practices (ACIP) recommendations Opens in new window

There is insufficient evidence to determine the effect of vitamin C or vitamin D supplementation in the prevention (or treatment) of pneumonia.[68]Padhani ZA, Moazzam Z, Ashraf A, et al. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database Syst Rev. 2021 Nov 18;11:CD013134. https://www.doi.org/10.1002/14651858.CD013134.pub3 http://www.ncbi.nlm.nih.gov/pubmed/34791642?tool=bestpractice.com [69]Public Health England. Insufficient evidence for vitamin D preventing or treating ARTIs. Jul 2020 [internet publication]. https://www.gov.uk/government/news/insufficient-evidence-for-vitamin-d-preventing-or-treating-artis