Lowering the Age for Pneumonia Vaccines

The CDC’s Advisory Committee on Immunization Practices (ACIP) plays a pivotal role in safeguarding the health of Americans. By continuously reviewing the latest scientific evidence and making vaccine recommendations, ACIP helps protect the public from a variety of infectious diseases. Their decisions not only shape individual vaccination protocols but also have profound impacts on public health outcomes, reducing preventable illnesses, hospitalizations, and healthcare costs.

Vaccines are among the most powerful tools we have to prevent disease. They save millions of lives every year, prevent long-term complications, and reduce the burden on our healthcare system. Among these, pneumonia vaccines have saved millions of lives since they were introduced and have prevented life-threatening complications related to pneumonia.

ACIP will revisit and adjust the age-based recommendations for pneumonia vaccines at its October meeting. Currently, the routine recommendation for adults to receive pneumonia vaccines begins at age 65, but there is compelling evidence to support lowering that age to 50. Doing so would not only make good public policy sense but would also help protect millions of Americans from preventable illness.

Why Lowering the Age-Based Recommendation Makes Sense

Lowering the routine recommendation for pneumonia vaccines from age 65 to 50 reflects a proactive approach to public health. By age 50, many individuals have already experienced a decline in immune function and are increasingly susceptible to infections like pneumonia.

Moreover, many in this age group are living with chronic conditions—such as heart disease, diabetes, and COPD—that make them even more vulnerable to severe pneumococcal disease. The cost of treating pneumonia, especially when it leads to hospital stays or intensive care, far outweighs the cost of preventing the disease. By expanding the routine vaccination recommendation to adults aged 50 and older, we could significantly reduce healthcare expenditures, avoid preventable illnesses, and increase overall life expectancy in this population.

ACIP Should Not Choose One Vaccine Over Another

In lowering the adult age to 50, ACIP should not choose one vaccine over all others for several reasons.

First, of the most compelling reasons to advocate for lowering the age-based recommendation is the need for sequential use of pneumonia vaccines in at-risk individuals. For example, adults aged 50-65 with chronic health conditions, such as chronic obstructive pulmonary disease (COPD) or diabetes, are at an increased risk for serious pneumococcal infections.

Take, for instance, a 55-year-old patient with COPD. This patient’s compromised lung function puts them at higher risk for pneumonia and its complications. In such cases, a sequential approach to vaccination is critical.

This sequential use of vaccines ensures that individuals like the COPD patient receive comprehensive protection against both common and more unusual strains of pneumococcal bacteria. The combination of these vaccines helps reduce the risk of severe infections, hospitalizations, and potentially fatal outcomes.

By lowering the routine recommendation to age 50, we can ensure that at-risk individuals begin receiving these vital vaccines earlier, offering them sequentially when necessary to provide the best possible protection when they need it most.

Second, recommending both vaccines reduces the risk of shortages during disease outbreaks or supply chain disruptions. In recent years, we’ve witnessed how fragile medical supply chains can be, as seen during the COVID-19 pandemic.

When a single vaccine is favored over others, the risk of shortages increases in times of heightened demand, leaving vulnerable populations without access to life-saving protection. By recommending both vaccines, we create redundancy in the system, ensuring that if one manufacturer faces supply chain issues, the other can step in to fill the gap.

The diversification of vaccine supply mitigates the impact of production slowdowns and ensures continuous protection for the population. This is especially important during respiratory illness outbreaks when demand for pneumonia vaccines can spike. With both vaccines available and recommended, healthcare providers have more flexibility to vaccinate patients without delays due to potential shortages.

Furthermore, endorsing both vaccines will encourage continued innovation in vaccine development. When multiple vaccine options are supported, pharmaceutical companies have incentives to improve their products, compete for market share, and explore new ways to enhance vaccine efficacy, safety, and delivery methods. If ACIP were to favor one vaccine exclusively, it could stifle this competitive drive, leading to slower progress in future vaccine advancements.

Multiple options also promote pandemic readiness by maintaining a robust pipeline of vaccine manufacturing, research, and distribution networks. By fostering competition and supporting both types of vaccines, the ACIP would contribute to a more dynamic vaccine industry that is better equipped to handle future public health emergencies.

Why a Clearer, Broader Recommendation Benefits Public Health

Finally, providing a clearer, broader recommendation for pneumonia vaccination starting at age 50 has far-reaching benefits beyond preventing disease. It builds goodwill among the public, healthcare providers, and public health professionals by showing that the agency is focused on protecting health in the most comprehensive way possible.

A broader recommendation simplifies the decision-making process for both healthcare providers and patients. When recommendations are clear, consistent, and based on strong evidence, providers can confidently advise their patients without having to navigate complex vaccine choices. This clarity reduces vaccine hesitancy and ensures higher uptake among patients, particularly in high-risk groups.

Further, the move will help the CDC and ACIP build trust with the American public. In an era where vaccine skepticism has grown, clear, consistent, and proactive public health measures signal to the public that their well-being is a priority. By expanding access to pneumonia vaccines and making evidence-based decisions, the ACIP will send a message that they are committed to protecting everyone, especially those at risk of severe disease.

Lastly, by avoiding favoritism toward one vaccine over the other, the ACIP preserves flexibility for healthcare providers. Different vaccines may be more appropriate depending on an individual’s health history, age, or risk factors. Offering the full range of vaccine options ensures that providers can tailor recommendations to their patients’ needs, ultimately leading to better health outcomes.

Conclusion

The CDC’s Advisory Committee on Immunization Practices has a crucial opportunity to make a profound impact on public health by lowering the age-based recommendation for pneumonia vaccines to 50. Such a decision would protect millions of people, reduce preventable illness, and ease the burden on our healthcare system.

At the same time, moving forward with a broader, more inclusive approach to vaccine recommendations—without favoring one vaccine over the other—ensures that healthcare providers can deliver the best possible care for their patients. It will build goodwill by ensuring that the supply chain remains resilient, innovation continues to flourish, and the public can trust that their health is in good hands. In doing so, ACIP will pave the way for a healthier, more resilient future for all Americans.

Dr. Robert Goldberg is Vice President of Research Programs at the Center for Medicine in the Public Interest.