Community-acquired pneumonia primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

There are several ways to prevent infectious pneumonia. Appropriately treating underlying illnesses (such as AIDS), smoking cessation, vaccination against pneumococcal and influenza are the commonly used methods.

Vaccination

Vaccine	Route of Administration	Type of Vaccine	Recommended Groups	Specific high-risk indications for vaccination	Re-vaccination schedule
Pneumococcal Vaccine	Intramuscular injection	Pneumococcal conjugate vaccine (PCV13)	All adults 65 years of age or older should receive a dose of PCV13 followed by a dose of PPSV23 6 to 12 months later	CSF leaks Cochlear implants Sickle cell disease/other hemoglobinopathies Congenital or acquired asplenia Congenital or acquired immunodeficiencies HIV infection Chronic renal failure Nephrotic syndrome Leukemia Lymphoma Hodgkin disease Generalized malignancy Iatrogenic immunosuppression‡ Solid organ transplant Multiple myeloma	No revaccination
Pneumococcal Vaccine	Intramuscular injection	Pneumococcal polysaccharide vaccine (PPSV23)	All persons > 65 years of age, 6-12 months before or after PCV13	Chronic heart disease Chronic lung disease Diabetes mellitus CSF leaks Cochlear implants Alcoholism Chronic liver disease Cigarette smoking Sickle cell disease/other hemoglobinopathies Congenital or acquired asplenia Congenital or acquired immunodeficiencies HIV infection Chronic renal failure Nephrotic syndrome Leukemia Lymphoma Hodgkin disease Generalized malignancy Iatrogenic immunosuppression Solid organ transplant Multiple myeloma	One-time revaccination, 5 years after first dose in the following patients: Sickle cell disease/other hemoglobinopathies Congenital or acquired asplenia Congenital or acquired immunodeficiencies HIV infection Chronic renal failure Nephrotic syndrome Leukemia Lymphoma Hodgkin disease Generalized malignancy Iatrogenic immunosuppression Solid organ transplant Multiple myeloma
Inactivated Influenza Vaccine	Intramuscular injection	Killed virus	All persons > 50 years of age, High-risk persons 6 months–49 years of age, household contacts of high-risk persons, health care providers, children 6–23 months of age	Chronic cardiovascular or pulmonary disease (including asthma) Chronic metabolic disease (including diabetes mellitus) Renal dysfunction Hemoglobinopathies Immunocompromising conditions/medications Compromised respiratory function or increased aspiration risk Pregnancy Aspirin therapy in persons < 18 years of age	Annualy
Live Attenuated Influenza Vaccine	Intranasal spray	Live virus	Healthy persons 5–49 years of age,a including health care providers and household contacts of high-risk persons	Avoid in high-risk persons	Annualy
Adapted from IDSA/ATS Consensus Guidelines on the Vaccine Prevention for Community-Acquired Pneumonia in Adults.