Pneumonia is an infection of the lungs that causes cough, fever, and trouble breathing. It can cause serious illness in young children, people over age 65, and people with other health problems. Pneumonia may affect one or both lungs.
The pneumonia vaccine is the term used for a vaccine that protects against pneumococcal disease, caused by infection with the Streptococcus pneumoniae bacterium, which are among the most common causes of pneumonia and upper respiratory infections. The pneumonia vaccine does not prevent all types of lung infections or all types of pneumonia.
There are two vaccines that protect against pneumococcal disease:
- PCV13 (pneumococcal conjugate vaccine, Prevnar 13)
- protects against 13 of the approximately 90 types of pneumococcal bacteria that can cause the most serious types of pneumococcal disease, including pneumonia, meningitis, and bacteremia
- The Centers for Disease Control (CDC) recommends PCV13 for
- All children younger than 2 years old
- People 2 years or older with certain medical conditions
- Some adults 65 years or older, as advised by their doctor
- PPSV23 (pneumococcal polysaccharide vaccine, Pneumovax 23)
- Protects against 23 types of pneumococcal bacteria
- Helps prevent invasive infections like meningitis and bacteremia
- The CDC recommends PPSV23 for
- All adults 65 years or older
- People 2 through 64 years old with certain medical conditions
- Adults 19 through 64 years old who smoke cigarettes
It is unknown how long the PCV13 vaccine lasts, however, revaccination with the PCV13 vaccine is not recommended for any age or risk group.
The PPSV23 vaccine lasts between five to 10 years. Effectiveness starts to wane after five to seven years, and the antibody response reaches near pre-vaccination levels at about 10 years. Revaccination with the PPSV23 vaccine is recommended:
- In patients with impaired splenic function, cerebrospinal fluid (CSF) leaks, and cochlear implants, or other head, neck, or spinal defects that may result in communication with the subarachnoid space: revaccinate every five to seven years
- In patients who have immunocompromising conditions: revaccinate every five to 10 years
- For all other at-risk individuals: revaccinate every 10 years
What Are Symptoms of Pneumonia?
Symptoms of pneumonia include:
- Cough: cough may produce phlegm or mucus that may be greenish, yellow, or bloody
- Sharp pain on inhalation or when coughing
- Difficulty breathing
- Shortness of breath
- Rapid, shallow breathing
- Fever
- Chills and shaking
- Fast heartbeat
- Sweating
- Loss of appetite
- Lack of energy
- Nausea and vomiting, especially in small children
- Confusion, especially in older people
What Causes Pneumonia?
Common causes of pneumonia include bacteria, viruses, and fungi.
Typical bacteria that cause pneumonia include:
- Streptococcus pneumoniae (most common bacterial cause)
- This is the bacteria the pneumonia vaccines protect against
- Group A streptococci
- Staphylococcus aureus
- Haemophilus influenzae
- Moraxella catarrhalis
- Aerobic gram-negative bacteria (e.g., Enterobacteriaceae such as Klebsiella spp or Escherichia coli)
- Microaerophilic bacteria and anaerobes (associated with aspiration)
Atypical bacteria that cause pneumonia include:
Respiratory viruses that cause pneumonia include:
- Adenoviruses
- Coronaviruses (e.g., Middle East respiratory syndrome coronavirus, COVID-19)
- Human bocaviruses
- Human metapneumovirus
- Influenza (“flu”) A and B viruses
- Parainfluenza viruses
- Respiratory syncytial virus
- Rhinoviruses
How Is Pneumonia Diagnosed?
Pneumonia is diagnosed with a patient history and physical exam, in which a doctor will check the lungs with a stethoscope to listen for crackling, rumbling, and bubbling and sounds when a patient inhales.
Tests used to confirm pneumonia include:
- Blood tests
- Polymerase chain reaction (PCR)
- COVID-19
- Influenza
- Sputum test on a sample of mucus (sputum) taken after a deep cough
- Urinary antigen testing for S. pneumoniae
- Chest X-ray
- Pulse oximetry to measure the blood oxygen levels
- Arterial blood gas test, to measure the amount of oxygen in a blood sample from an artery
- Computerized tomography (CT) scan of the chest
- Pleural fluid culture, in which a small amount of fluid is removed from tissues surrounding the lung
- Bronchoscopy, in which a tube with a light on the end is used to look into the airways
What Is the Treatment for Pneumonia?
Treatment for pneumonia depends on the type of pneumonia, the severity, the patient’s age, and if other health conditions are present.
Medications used to treat pneumonia include:
- Antibiotics, if the cause is bacterial
- Antivirals, if the cause is viral
In many cases, managing symptoms and rest are sufficient. Home care for pneumonia may include:
- Getting plenty of rest
- Drinking a lot of fluids
- Warm beverages can help open airways
- Fever reducers
- Steamy baths or showers or using a humidifier to help open airways
- Don’t smoke and avoid secondhand smoke or any other lung irritants
- Talk to your doctor before taking cough medicines because coughing helps the body work to get rid of infection
For severe cases, patients may need to be hospitalized, and treatment may include:
- Intravenous (IV) fluids
- Intravenous antibiotics
- Oxygen therapy
- Other breathing treatments
What Are Complications of Pneumonia?
Complications of pneumonia are more likely to occur in very young children, older adults, people with compromised immune systems, and people who have other chronic medical problems such as diabetes or cirrhosis of the liver.
Complications of pneumonia may include:
- Respiratory failure
- Sepsis: a severe response to an infection that can be a life-threatening medical emergency
- Acute respiratory distress syndrome (ARDS)
- Lung abscesses (rare but serious)
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