Primary prevention

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. [ Cochrane Clinical Answers logo ]

Advisory Committee on Immunization Practices (ACIP) vaccination recommendations:[66]

  • 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 leak, or a cochlear implant should also be vaccinated according to this schedule; a minimum interval of 8 weeks between PCV15 and PPSV23 can be considered for these vulnerable groups, to minimize the risk of invasive pneumococcal disease caused by serotypes unique to PPSV23 in these patients. Patients who have received PPSV23 previously (but not PCV13) should receive either PCV20 or PCV15 at least 1 year after PPSV23. Adults with previous PCV13 should complete the previously recommended PPSV23 series.[67]

  • 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][69]

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