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.
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Pneumococcal vaccination is part of the routine vaccination schedule for children which is an effective way to reduce the burden of the disease in both children and adults.
CDC: immunization schedules
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Advisory Committee on Immunization Practices (ACIP) vaccination recommendations:[71] CDC: immunization schedules Opens in new window
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.[71]
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.[71] 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.[71]
Adults aged 19 years and older should receive an annual influenza vaccination with an age-appropriate formulation, provided they do not have a contraindication. CDC: immunization schedules Opens in new window
RSV vaccines are recommended for all adults age 75 years and older, and adults ages 50-74 years who are at increased risk for severe RSV.[72] In April 2025, ACIP expanded its RSV vaccine recommendation to include those ages 50-59 years who are at an increased risk for RSV-associated lower respiratory tract disease.[73] Given the high burden of the disease, especially among vulnerable populations, development of the RSV vaccination represents an important preventive measure to reduce severe outcomes in older adults.
Further details on current vaccination schedules and special patient populations can be found in the latest ACIP vaccination schedule. CDC: adult immunization schedule by age: recommendations for ages 19 years or older, United States, 2025 Opens in new window
Patients with chronic conditions that require immunosuppressants are at increased risk of infection, such as community-acquired pneumonia, and should be offered the pneumococcal vaccination. A recent report from the National Institute for Health and Care Research (NIHR) in the UK found the pneumococcal vaccine was protective against hospitalization and death due to pneumonia in people with inflammatory diseases; it also provided reassurance that the vaccine is not associated with disease flares.[74]
The PSERENADE project compiled the largest and most globally diverse invasive pneumococcal disease (IPD) surveillance database that looked at data up to 2019 from countries with high PCV10 and PCV13 uptake in childhood immunization programs. The findings showed that 6 years after the introduction of PCV10 or PCV13, all IPD incidence in children younger than 5 years declined by 58% to 74% relative to the pre-PCV period, and 4% to 29% in adults 65 years and older.[75]
One literature review shows that adult vaccine coadministration is generally safe, with most adverse events being mild to moderate and short-lived. Evidence indicates that coadministration does not compromise the effectiveness of vaccines, including coronavirus disease 2019 (COVID-19), influenza, RSV, and tetanus, diphtheria, and pertussis (Tdap) vaccines. The main benefits of vaccine coadministration include greater convenience, fewer missed opportunities for vaccination, and more efficient use of healthcare resources.[76]
There is insufficient evidence to determine the effect of vitamin C or vitamin D supplementation in the prevention (or treatment) of pneumonia.[77][78]