William Schaffner, MD, professor of preventive medicine and infectious diseases, Vanderbilt University Medical Center, Nashville.
Pneumonia can happen any time—not just during the cold months. And since it can become very serious, even life-threatening, prevention should be your top priority, especially if you’re immunocompromised…have long-term health issues…or are over age 65. Bottom Line Personal asked infectious disease specialist William Schaffner, MD, what you need to know and how to protect your health…
There is more than one type. People most often contract pneumonia through exposure to a strain of the pneumococcal bacteria Streptococcus pneumoniae.
Secondary pneumonia can develop as a complication of a viral infection. How this happens: We all carry some bacteria in our throat all the time. Those bacteria come and go, but if you get the flu, for instance, that virus can irritate the throat down to the bronchial tubes—paving the way for the normal bacteria to become more active, move down into the lungs and cause pneumonia.
Walking pneumonia is community-acquired—you contract it during your normal life. Typically, you walk into your doctor’s office feeling awful…he/she diagnoses pneumonia…and you walk out with a prescription for antibiotics. If promptly diagnosed and treated, most people can recuperate at home.
Health-care–associated pneumonia is acquired during or after a stay in a health-care setting, such as the hospital or a long-term-care facility, and often is more antibiotic-resistant.
Pneumonia can be prevented. Some of us are more susceptible to pneumonia—adults age 65 or older…children under age five…anyone with a long-term health issue or a weak immune system…and people who smoke. Prevention, always better than needing treatment, requires a two-pronged approach—a healthy lifestyle and the right vaccines.
Vaccines. The Centers for Disease Control and Prevention (CDC) recommends pneumococcal vaccinations for all adults age 65 or older, for children under age five and for people between those ages with certain underlying medical conditions, including diabetes, heart disease and lung disease.
There are three different vaccines available, some more appropriate for certain people than others. They are the pneumococcal polysaccharide vaccine PPSV23…and the pneumococcal conjugate vaccines PCV15 (followed a year later by PPSV23) and PCV20. The numbers indicate how many strains, or serotypes, of Streptococcus pneumoniae are included in the vaccine. The formulas of pneumococcal conjugate vaccines (which use a protein to carry the different serotypes) differ from the polysaccharide vaccine (which uses polysaccharides, or chains of complex sugars, to carry the vaccine).
Which vaccine should you get?
If you have never been vaccinated for pneumonia, the newer PCV20 is the top choice—it covers the 20 most common serotypes now.
If that vaccine is not available in your area, you can get the PCV15 vaccine, followed one year later by PPSV23.
If you had the earlier PCV13 (but not PCV 15), you’re likely eligible to get the PCV20 for increased protection.
Best: Because of all the possibilities, talk to your doctor about the most effective approach for you.
Side effects include feeling achy and tired as well as redness, swelling and soreness at the injection site. If you experience any side effect, ask your provider if it’s safe for you to take a pain-relief medication such as acetaminophen.
You still need other vaccines. To avoid getting pneumonia as a consequence of a viral infection, protect yourself with the following vaccines…
Flu vaccine. Each year, the flu vaccine targets the strains projected to be most common. It can reduce risk for illness by 40% to 60%.
Respiratory syncytial virus (RSV) vaccine. This new vaccine was approved for people age 60 and older (it’s now being studied for other age groups including infants). It reduces risk for a lower respiratory tract infection by about 85%. If you’re not yet 60 but have an underlying chronic heart or lung condition, ask your doctor if you are a candidate for the RSV vaccine. Note: This off-label use may not be covered by insurance (cost about $300). As of now, only one dose is being recommended. Possible side effects: There were some “signals” about neuroinflammatory illnesses and atrial fibrillation associated with the RSV vaccine, but the risk is very low.
COVID-19 vaccine and boosters. SARS-CoV-2, the virus that causes COVID-19, can make you vulnerable to secondary pneumonia. This year’s COVID vaccine has an efficacy rate of up to 95% for preventing symptomatic and serious illness. Annual updated vaccines likely will be needed indefinitely to maintain that level of protection.
While vaccines cannot prevent every case of pneumonia (or the other conditions they’re given for), people who are vaccinated usually have milder infections, a shorter course of illness and fewer serious complications than people who don’t get vaccinated. The flu, RSV and COVID booster shots all can be given simultaneously.
The same steps to avoid viruses will help you avoid pneumonia. Stay away from people who are sick and…
Regularly wash your hands with soap and water.
Regularly disinfect common surfaces at home and at work.
Keep chronic medical conditions under control, including asthma, high blood pressure and diabetes.
Maintain overall good health and a strong immune system through regular exercise and healthy eating.
Don’t smoke. Smoking inhibits your lungs from doing their key job—filtering out germs to keep you healthy.
Despite your best intentions, it still is possible to get pneumonia. Signs of pneumonia that require immediate attention include difficulty breathing or shortness of breath…chest pain when you breathe or cough…coughing with or without mucus (sputum). You may also have classic flu-like symptoms, such as fever and chills, headache, muscle pain, fatigue, nausea and/or vomiting, and diarrhea. If you’re an older adult or have a serious illness or a weakened immune system, your symptoms could include a lower-than-normal temperature and feeling weak or confused.
Antibiotics. Most people feel better after one to three days, but take the full course prescribed along with any other medications. Let your doctor know if your symptoms don’t improve—you may need a different antibiotic.
Pain relievers. Acetaminophen (Tylenol) can help with achiness.
Fluids. Stay hydrated.
Important: Unless your cough prevents you from sleeping, avoid cough suppressants so your body can bring up and eliminate sputum.
For a severe case of pneumonia: You may need treatment in a hospital, where you can get antibiotics and fluids intravenously along with supplemental oxygen.