Pneumonia causes death in about 1 in 20 people who get infected. Yet in 2024, 25.1% of adults 18 years and older had never received a pneumonia vaccine. Pneumococcal vaccines are effective in helping to prevent patients from getting pneumonia. There are currently four pneumococcal vaccines available: PCV15, PCV20, PCV21, and PPSV23. It can be hard for patients to identify which vaccine is right for them. Pharmacists can play a role in selecting and administering the proper pneumococcal vaccine for a patient.

What is Pneumonia?

Pneumonia is a respiratory tract infection caused by viruses, bacteria, or fungi. Pneumonia can be classified into three different groups; community-acquired, hospital-acquired, and ventilator-associated.

Symptoms of Pneumonia

• Cough
• Shortness of breath
• Fever
• Chest pain when breathing
• Fatigue

While some patients may have mild cases of pneumonia, others can get a very severe infection. Patients who have an increased risk for severe pneumonia include people who are 65 years or older, children younger than 5 years old, immunocompromised patients, and patients with conditions such as heart disease, liver disease, lung disease, and diabetes. It is especially important for people with an increased risk of pneumonia to be vaccinated to help prevent complications of severe pneumonia.

How Can Pneumonia be Prevented?

While vaccination is the best way to prevent pneumonia, there are things that patients can do to help reduce their risk. Pneumonia is spread through respiratory droplets. Respiratory droplets can be expelled when someone with pneumonia coughs, sneezes, talks, or breaths. Using good hygiene practices such as hand washing, disinfecting surfaces, covering the mouth and nose when coughing or sneezing, and avoiding those who are sick.

Pneumonia Vaccine Overview

Pneumococcal vaccines are inactivated vaccines. Pneumococcal vaccines are generally well tolerated. The most common side effects are flu-like symptoms. Side effects will usually resolve in about 2 days. When deciding which vaccine to administer, age, previous pneumococcal vaccination history, and allergies are important things to consider.

While all pneumonia vaccines can help prevent pneumonia, each covers a unique set of pneumonia strains. Patients and their provider or pharmacist should use shared clinical decision-making to decide which vaccine is best for the patient.

Vaccination Schedule

Pneumococcal vaccines are recommended primarily in children and adults over 50 years old. Immunocompromised patients may also be able to receive pneumococcal vaccines depending on their condition and previous vaccination history. These groups are targeted because they are at the highest risk for acquiring severe pneumonia.

Children are typically given a 4-dose pneumococcal vaccine sequence starting at around 2 months of age. Some parents may delay vaccination and later pursue a catch-up schedule. Other families may begin a pneumococcal vaccine sequence and not complete it on schedule due to scheduling or health concerns. There will be different schedules available for these families to follow to ensure their child is protected against pneumonia.  

Adults typically will not receive a pneumococcal vaccine unless they are over the age of 50 years. When deciding which vaccine to give to adult patients, previous vaccination history is important to obtain. Depending on which vaccines may have been given, there may be some pneumococcal vaccines that are preferred over others.

Some patients who are immunocompromised or have health conditions that increase the risk of severe pneumonia may be eligible for additional pneumococcal vaccines. In these patients, CDC recommendations and shared-clinical decision making with the patient’s healthcare provider or pharmacist should be used.

How Can Pharmacists Choose the Right Pneumococcal Vaccine for Their Patients?

Pharmacists should obtain an adequate patient history including medical conditions, allergies, and previous vaccination history. Pharmacists should be familiar with CDC vaccination schedules and reference them when evaluating patient eligibility for any vaccine. One helpful resource is the PneumoRecs VaxAdvisor app from the CDC. This app allows healthcare professionals to enter relevant patient information in order to get a specific recommendation on which pneumococcal vaccines are right for the patient. Knowledge of both pneumococcal vaccine differences and recommended administration schedules will allow pharmacists to continue to play a key role in protecting patients from pneumonia.

Kailee G., APPE student

Sources:

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