World Pneumonia Day: Protecting Europe’s Ageing Population Through Prevention
November 12, 2025
Blog by Nicoletta Luppi, Senior Vice President and Managing Director at MSD Italia
On World Pneumonia Day, Europe faces a stark reminder: pneumonia is not only a deadly disease, but a warning sign of the wider challenge posed by respiratory infections. Influenza, COVID-19, RSV in newborns and in elderly, and pneumococcal disease (PD) continue to claim thousands of lives each year, stretching health systems already under strain. One of the most effective ways to reduce this burden is through immunisation — a proven, preventive tool that saves lives and strengthens resilience.
Pneumococcal disease, caused by Streptococcus pneumoniae, can lead to severe conditions such as sepsis, meningitis and pneumonia — particularly in older adults and infants. In 2023, over 24,000 cases of IPD – invasive pneumococcal disease, the most severe and invasive form of pneumococcal infections – were reported across the EU, and those aged over 65 face a threefold higher risk of infection, making prevention an urgent priority [1].
Europe’s demographic shift adds further pressure. People aged 65 and over already make up over one-fifth of the population, and this will rise to nearly one-third by 2050 [2]. Without stronger preventive measures, the health and economic toll of respiratory infections – already costing billions annually – will continue to escalate.
Immunisation against pneumococcal and other respiratory infections protects the youngest and oldest members of society, as well as those with chronic conditions, including cardiovascular, COPD and cancer patients. Yet adult vaccination rates remain alarmingly low, far behind those for children and seasonal influenza. Surveillance of pneumococcal disease is not optimal across the EU, with important disparities among EU countries [3]. Closing these gaps is essential to protect ageing populations and ensure sustainable health systems. A positive example of how this can be implemented comes from Italy, where the NIP establishes a target pneumococcal vaccination coverage rate of 75% for cohort of adults aged 65 years.
Pneumococcal vaccination can also help fight antimicrobial resistance (AMR). Real-world evidence demonstrates that immunisation against pneumococcal disease decreased pathogen carriage and infections in individuals 65 years of age or older, substantially reduced antibiotic prescriptions and diminished the circulation of resistant strains [4].
For these reasons, the Steering Group on Prevention of Respiratory Infections is calling for a new EU Council Recommendation to strengthen action on immunisation against respiratory infections — including influenza, COVID-19, RSV and pneumococcal disease [5]. Establishing clear coverage targets increases political accountability, and integrating vaccination across EU health policies such as the EU cardiovascular health plan can help close the life-course immunisation gap and build a stronger, more resilient Europe.
The case for prevention extends far beyond infection control. Respiratory infections such as flu and pneumococcal disease can trigger serious cardiovascular complications. Evidence shows that a flu infection increases the risk of a heart attack sixfold in people with cardiovascular disease [6], with other respiratory infections causing a 3-times increase in the risk of a stroke [7]. Thus, vaccination against respiratory infections can reduce the risk of complications associated with CVD [8]. Immunisation is therefore not only an infectious disease measure — it is also cardiovascular prevention.
As the EU develops its Cardiovascular Health Plan, it must fully integrate vaccination against respiratory infections as a key preventive measure, with concrete measures to increase uptake and means to measure progress via ECDC dashboards for better public health in Europe [9].
To take full advantage of the significant benefits of immunisation against respiratory infections, we must view prevention as an investment, not a cost. For instance, adult immunisation programmes return up to 19 times their initial investment, and for pneumococcal immunisation specifically, the return is up to 33 times [10]. Despite this, only 0.5% of healthcare budgets in most EU Member States are dedicated to immunisation [11].
Investing in immunisation today means investing in Europe’s future — preventing disease, protecting vulnerable populations, and enabling healthier ageing for generations to come.
[1] https://atlas.ecdc.europa.eu/public/index.aspx
[3] https://pneumoniaatlas.org/#map-tabs|1
[4] https://pubmed.ncbi.nlm.nih.gov/34602924/
[6] https://pubmed.ncbi.nlm.nih.gov/29365305/
[7] https://www.nejm.org/doi/full/10.1056/NEJMoa041747
[8] https://www.nature.com/articles/s41598-023-47690-9
[10] https://www.ohe.org/publications/the-socio-economic-value-of-adult-immunisation-programmes/