Pneumonia is a serious lung infection that can be life-threatening, especially for older adults. Getting vaccinated against pneumonia is an important way for people over 65 to protect themselves. But with different types of pneumonia vaccines available, it can get confusing about how often you actually need to get vaccinated. Let’s take a closer look at the recommendations for pneumonia vaccination for seniors.
What is Pneumonia?
Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi. It causes inflammation in the air sacs of the lungs, making it difficult to breathe and get enough oxygen into the bloodstream. Some of the common symptoms of pneumonia include:
- Cough with phlegm or mucus
- Fever and chills
- Shortness of breath
- Chest pain when breathing or coughing
- Fatigue
Pneumonia can range from mild to so severe that you have to be hospitalized. It tends to be more serious for older adults, as well as people with other health conditions like heart or lung disease, diabetes, or a weakened immune system.
The two most common causes of pneumonia are:
- Bacterial pneumonia – caused by bacteria like Streptococcus pneumoniae. This is the most common type in adults.
- Viral pneumonia – caused by viruses like influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 (the virus that causes COVID-19).
Why Seniors are at Higher Risk
As we age, our immune systems naturally weaken, making it harder to fight off infections like pneumonia. Changes to the lungs as we get older also make us more prone to pneumonia. Other factors that increase risk include:
- Chronic health conditions – Things like heart disease, lung disease, diabetes, and kidney disease are linked to higher pneumonia risk.
- Smoking – The lungs become damaged over time.
- Medications – Some drugs like sedatives suppress the cough reflex needed to clear mucus.
- A weakened immune system – This can be caused by medication, malnutrition, or other diseases.
- Difficulty swallowing – This can allow food and fluids to get into the lungs.
According to the CDC, pneumonia causes over 250,000 hospitalizations and about 50,000 deaths each year in people aged 65 and older. It is the most common cause of sepsis and the 8th leading cause of death overall in this age group.
Pneumonia Vaccines for Seniors
Vaccines are available that can help protect against some of the most common and dangerous causes of pneumonia. The two main ones that are recommended for seniors are:
Pneumococcal Conjugate Vaccine (PCV13)
- Protects against 13 strains of Streptococcus pneumoniae, the leading cause of bacterial pneumonia.
- Recommended for all adults 65+ who have not previously received this vaccine.
- Usually only needs to be given once in a lifetime.
Pneumococcal Polysaccharide Vaccine (PPSV23)
- Protects against 23 strains of pneumococcal bacteria.
- Recommended for all adults 65+.
- Should be given at least 1 year after receiving PCV13.
- May need a booster dose after 5 years.
Some key points about the pneumococcal vaccine recommendations:
- PCV13 should be given first, followed by PPSV23 at least 1 year later.
- If you received PPSV23 before age 65, you should still get PCV13 at age 65 or later, at least 1 year after your last PPSV23 dose.
- If you received PPSV23 at age 65 or later, there is no recommendation to receive PCV13. But it may be considered on an individual basis.
- Talk to your doctor to confirm your history of receiving these vaccines.
How Often to Get the Pneumonia Vaccine Over 65
Here is a summary of the current CDC recommendations on how often people over 65 should plan to receive the different pneumonia vaccinations:
PCV13
For adults over the age of 65 who have not previously received PCV13, it is recommended to get this vaccine once at age 65 or later. Only one dose is needed.
Some people may get PCV13 before age 65 for certain medical conditions. In that case, they would not need another dose at age 65 as long as they received it over age 50.
PPSV23
All adults 65+ should get one dose of PPSV23, at least 1 year after receiving PCV13 (if applicable).
Some people may need additional boosters of PPSV23:
- People aged 65+ who received their previous PPSV23 dose before age 65 should get another dose at least 5 years later, or by age 68.
- People who have certain medical conditions like asthma, heart disease, lung disease, diabetes, cirrhosis, smoking, or lack of a spleen may need a booster dose as early as 5 years after their previous PPSV23.
- Those with weakened immune systems may need PPSV23 boosters after just 1 year.
- For most healthy adults 65+, only one lifetime booster (so 2 total doses) is recommended.
Talk to your doctor to confirm if you need more frequent PPSV23 boosters based on your medical history and health status.
What About the Flu Shot?
The seasonal influenza vaccine does not protect against pneumonia specifically. But it can reduce your risk of viral pneumonia caused by the flu.
The CDC recommends that all seniors get a flu shot every year, ideally before flu season starts. This should be given in addition to your scheduled pneumonia vaccines.
Getting vaccinated against both influenza and pneumococcal disease provides the best protection for older adults against these potential deadly respiratory illnesses.
Ask Your Doctor Which Vaccines You Need
To summarize, here are some key questions to ask your doctor about pneumonia vaccinations:
- Have I received PCV13 and/or PPSV23 before? If so, when?
- Do I need PCV13 now that I am over 65?
- When should I get PPSV23 in relation to PCV13 if needed?
- How often will I need a PPSV23 booster based on my health status?
- Am I up-to-date on my annual flu shot?
Following the recommended vaccination schedule for both pneumonia and flu shots can greatly lower your risk of coming down with these serious respiratory illnesses. Be sure to consult with your physician to ensure you are up-to-date with the vaccines appropriate for your age and health status.
How the Vaccines Work
Understanding how pneumonia vaccines provoke an immune response can help explain the rationale behind the vaccination schedule recommendations.
Pneumococcal polysaccharide vaccines like PPSV23 contain purified capsular polysaccharides from different strains of Streptococcus pneumoniae bacteria. When injected, these polysaccharides trigger B lymphocytes to create antibodies against the bacterial capsules. These antibodies can then recognize and opsonize (coat) pneumococcus bacteria if you become infected, marking the pathogens for destruction by phagocytes.
The downside is that polysaccharide antigens produce a weaker and shorter-lived antibody response compared to vaccines containing conjugated proteins. They also do not educate the immune system to mount stronger responses upon subsequent infections.
This is why a first dose of PCV13 is now recommended. PCV13 uses a different formulation known as conjugated polysaccharides. Here, the polysaccharide antigens are chemically linked to a carrier protein. This conjugate vaccine stimulates stronger B cell activation and T helper cell stimulation for more robust and sustained antibody production.
PCV13 therefore provides better initial protection. Giving PPSV23 afterwards provides broader coverage against the 23 serotypes of pneumococcus included. The vaccines together provide both short-term immunity through PCV13 and longer-term protection with the PPSV23 booster.
However, protection from both vaccines gradually wanes over time, leading to the need for repeat PPSV23 boosters later in life to maintain sufficient antibody levels. This explains the schedule of the pneumococcal vaccines given at age 65+ and beyond.
Lifestyle Measures to Prevent Pneumonia
In addition to vaccination, some lifestyle precautions can help lower your pneumonia risk as you age:
Don’t Smoke
Smoking damages the lungs’ natural defenses against infection. Quitting smoking can help reduce your vulnerability to pneumonia.
Manage Chronic Conditions
Keep other conditions like diabetes, heart disease, and COPD well controlled with medication and healthy lifestyle habits. This helps keep your immune system resilient.
Eat a Nutritious Diet
Eat plenty of antioxidant-rich fruits and vegetables. Stay hydrated and get adequate protein to maintain strength and immunity.
Exercise Regularly
Stay active with cardio and strength training exercises to support lung and immune function.
Get Recommended Vaccines
In addition to the pneumonia shots, get annual flu shots and stay up-to-date on other immunizations like Tdap.
Practice Good Hygiene
Wash hands regularly, cough into elbows, and avoid touching the face to limit spread of bacteria and viruses.
Limit Exposure When Sick
Stay away from others if you are ill to prevent transmitting respiratory illnesses. Wear a mask if needing to go out.
Making healthy lifestyle choices along with following the recommended schedules for pneumonia and flu vaccines offers seniors the best protection against these severe lung infections. Speak with your doctor to ensure you get the appropriate vaccinations on schedule.
Conclusion
Pneumonia is a leading cause of hospitalization and death in older adults. Vaccination is an important measure to prevent pneumonia infection.
The CDC currently recommends:
- All adults 65+ should receive one dose of PCV13 pneumonia vaccine if they have not previously received it.
- All adults 65+ should receive one dose of PPSV23 pneumonia vaccine at least 1 year after PCV13.
- Those with certain medical conditions may require additional PPSV23 boosters, either every 5 years or even annually depending on health status.
- Seniors should also get an annual flu shot to reduce risk of viral pneumonia.
Talk to your doctor to confirm your vaccination history and determine if you require any pneumonia vaccines or boosters. Keeping up with recommended immunizations along with healthy lifestyle habits provide the best protection against pneumonia and other vaccine-preventable diseases for older adults.
