Burden of Pneumonia in Older Adults and the Role of Immunization

Lower respiratory infections remain the leading infectious cause of death worldwide, with pneumonia causing a substantial burden of morbidity, mortality, and long-term complications in older adults, particularly among those with chronic comorbidities, immunocompromising conditions, or those living in nursing homes. Streptococcus pneumoniae remains the leading bacterial pathogen, while influenza, SARS-CoV-2, and respiratory syncytial virus (RSV) are major viral causes of pneumonia and may predispose individuals to secondary bacterial infection. Vaccination is the cornerstone of prevention. Pneumococcal conjugate vaccines and vaccines against influenza, COVID-19, and RSV reduce clinically relevant respiratory outcomes in older adults, although the strength of evidence and the endpoints evaluated differ among vaccines. However, vaccination coverage remains suboptimal because of limited awareness, vaccine hesitancy, differences in immunization policies, and barriers to healthcare access. Improving vaccine uptake through life-course immunization strategies, strong recommendations from healthcare professionals, and equitable access could help reduce pneumonia burden among older adults.