Pneumonia is one of the world’s oldest diseases, and still one of its deadliest. It caused about 2.5 million deaths in 2023, including roughly 610,000 children under five, making it the single largest infectious cause of death in young children. Yet most cases can be prevented, and most can be treated if they’re caught early.
The theme for World Pneumonia Day on 12 November 2026 is “A New Era of Pneumonia Control”. It recognises how far vaccines, diagnosis and treatment have come, and how many lives are still lost because that progress hasn’t reached everyone. In India, a country that has made big gains in child immunisation, pneumonia is still a major cause of illness and death in both young children and older adults, especially in winter, when cold weather, respiratory viruses and air pollution add up.
This guide explains the warning signs to look out for at different ages, who is most at risk, and the vaccines that can protect you and your family.
At a glance
- Pneumonia is an infection of the lungs, usually caused by bacteria or viruses. It fills the tiny air sacs with fluid or pus, making it harder to breathe.
- Watch for a cough with fever, fast or difficult breathing, chest pain when you breathe or cough, and unusual tiredness. Older adults may simply seem confused or weak, without a high fever.
- In children, fast breathing and the lower chest pulling in with each breath are key warning signs. Get medical help the same day.
- Those most at risk are children under five, adults over 65, smokers and people with diabetes, heart, lung or kidney disease or a weak immune system.
- Vaccines are the best protection. In India, the pneumococcal conjugate vaccine (PCV) is given free to babies at 6 weeks, 14 weeks and 9 months under the Universal Immunisation Programme. Adults over 65 and those with long-term conditions should ask their doctor about pneumococcal and yearly flu vaccines.
- Everyday habits help too: handwashing, not smoking, cleaner air at home, good nutrition and exclusive breastfeeding for the first six months.
- Seek urgent help for breathing difficulty, bluish lips, chest pain, confusion, or a child who can’t drink or is unusually sleepy.
What is pneumonia?
Pneumonia is an infection that inflames the small air sacs (alveoli) in one or both lungs. Normally these sacs fill with air when you breathe in. In pneumonia they fill with fluid or pus, so less oxygen gets into your blood and breathing becomes painful and hard work.
According to the WHO, pneumonia is usually caused by viruses or bacteria and spreads mainly through contact with infected people, for example through coughs and sneezes.
- Streptococcus pneumoniae (pneumococcus) is the most common bacterial cause in both children and adults. Haemophilus influenzae type b (Hib) is another important cause in young children. Bacterial pneumonia is treated with antibiotics.
- Influenza (flu), respiratory syncytial virus (RSV), COVID-19 and measles can all cause pneumonia, or weaken the lungs so that a bacterial pneumonia follows. Antibiotics don’t work against viruses.
- Fungi and others. Less common, and mostly seen in people with weakened immune systems.
Pneumonia can be mild, sometimes called “walking pneumonia”, or severe enough to need hospital care and oxygen. A doctor diagnoses it by examining you, listening to your chest and sometimes ordering a chest X-ray, blood tests or a pulse oximeter reading. Don’t take leftover antibiotics or buy them without a prescription: the wrong antibiotic, or a course that’s stopped early, can make the infection harder to treat and adds to antibiotic resistance.
Warning signs of pneumonia
In adults
The WHO lists the common symptoms as cough, shortness of breath, fever with sweating and chills, tiredness and chest pain, sometimes with nausea, vomiting or diarrhoea. Look out for:
- a cough that may bring up yellow, green or rusty mucus
- fever, shivering or sweats
- breathing faster than usual, or feeling breathless doing everyday things
- a sharp chest pain that’s worse when you breathe in or cough
- feeling very tired and unwell, and losing your appetite
A cold or flu that seems to get better and then suddenly gets worse, with a higher fever and more breathlessness, can be a sign that pneumonia has set in.
In older adults
Older people often don’t have the “classic” symptoms. They may have little or no fever and only a mild cough. Instead, the WHO notes that pneumonia can show up as confusion, especially in older adults, along with weakness, falls, drowsiness or not eating. If an elderly parent suddenly seems confused or unusually weak, especially with a cough or breathlessness, get them checked the same day.
In babies and young children
Children under five may not be able to tell you they’re struggling, so the most important signs are in how they breathe. Count their breaths for a full minute while they’re calm or asleep. International guidelines used by Médecins Sans Frontières define fast breathing in children as:
| Age | Fast breathing |
| Under 1 month | 60 or more breaths a minute |
| 1–11 months | 50 or more breaths a minute |
| 1–5 years | 40 or more breaths a minute |
A child with a cough or cold who is breathing fast should see a doctor the same day.
Get urgent medical help, at any age, if there is:
- difficulty breathing, or the lower chest pulling in with each breath (chest indrawing) in a child
- bluish or grey lips, tongue or fingernails, or an oxygen reading below 90% on a pulse oximeter
- grunting, a whistling noise when breathing in, or the nostrils flaring
- confusion, unusual sleepiness or difficulty waking
- in a child, refusing to drink or feed, vomiting everything, or a fit
- chest pain, a racing heart or coughing up blood
- any breathing difficulty in a baby under two months
Call 112 or go to the nearest hospital emergency department. Don’t wait for a regular appointment.
Who is most at risk?
Anyone can get pneumonia, but the WHO identifies young children, adults over 65 and people with existing health conditions as most at risk. In more detail:
- Children under five, especially babies, those born early or small, and children who aren’t fully vaccinated. Malnutrition is linked to about 60% of child pneumonia deaths.
- Adults over 65, whose immune systems and cough reflex are weaker.
- People with long-term conditions, such as diabetes, asthma, COPD, heart disease, kidney or liver disease.
- People with weakened immunity, including those with HIV, cancer, an organ transplant, or taking steroids or other immune-suppressing medicines.
- Smokers, because smoking damages the lungs’ natural defences.
- People exposed to polluted air. Air pollution and smoking together account for more than one in four pneumonia deaths in adults over 70. In India, smoke from solid cooking fuels and winter smog both matter; our guide to air pollution and your health has practical tips.
- People who have recently had flu, COVID-19 or another respiratory infection, which can open the door to a bacterial pneumonia.
- People with swallowing difficulties, for example after a stroke, who may inhale food or drink into the lungs.
In children, Indian doctors also point to incomplete immunisation, not being exclusively breastfed, poor nutrition, overcrowding and indoor smoke as key risk factors.
The vaccines that protect against pneumonia
The WHO calls vaccination the most effective way to prevent pneumonia, naming vaccines against Hib, pneumococcus, measles, influenza and whooping cough (pertussis). No single vaccine prevents every type of pneumonia, but together they protect against many of the most common and dangerous causes.
For babies and children
India’s Universal Immunisation Programme (UIP) gives these free at government health centres:
- Pneumococcal conjugate vaccine (PCV): protects against pneumococcus, the leading bacterial cause of pneumonia. Under the UIP, it’s given free of cost at 6 weeks and 14 weeks, with a booster at 9 months.
- Pentavalent vaccine: includes Hib and whooping cough (pertussis), along with diphtheria, tetanus and hepatitis B.
- Measles-rubella (MR) vaccine: measles is a serious cause of pneumonia in children.
Check your child’s immunisation card or the U-WIN record, and catch up on any missed doses. Your paediatrician may also suggest a yearly flu vaccine for children from six months, especially those with asthma or other long-term conditions.
In India, doctors say vaccination has reduced the severity of pneumonia, and fully vaccinated children have better outcomes.
For adults
The Association of Physicians of India’s 2024 adult immunisation guidelines recommend pneumococcal and influenza vaccines for high-risk groups, including older adults, people with long-term conditions and healthcare workers.
| Vaccine | Who should ask about it | How often |
| Pneumococcal | Adults over 65, and younger adults with diabetes, heart, lung, kidney or liver disease, smokers, or a weakened immune system | Usually once (one or two doses depending on the vaccine). Your doctor will advise which vaccine and schedule suit you |
| Influenza (flu) | Adults over 65, pregnant women, people with long-term conditions, healthcare workers, and anyone who wants to lower their risk | Every year, ideally before the flu season in your region |
| COVID-19 | Follow current national advice, especially if you’re older or have a long-term condition | As advised |
| RSV | Newer vaccines for older adults and pregnant women are approved in some countries | Ask your doctor about availability in India |
| Tdap (whooping cough) | Pregnant women (to protect the baby) and adults who haven’t had a booster | As advised |
Adult vaccines are usually available at private hospitals, clinics and some pharmacies, and costs vary. If you’re over 60 or have a long-term condition, a winter check-up is a good time to ask. Our Dhanteras health guide lists other check-ups worth booking.
Everyday ways to lower your risk
Alongside vaccines, the WHO recommends handwashing, reducing indoor air pollution, not smoking, eating well and exclusive breastfeeding for the first six months.
- Wash your hands with soap and water, especially before eating or feeding a baby and after coughing, sneezing or caring for someone who’s ill.
- Cover coughs and sneezes, and keep babies and older relatives away from people with colds or flu where you can.
- Stop smoking, and keep homes and cars smoke-free. Second-hand smoke raises the risk for children.
- Cleaner air at home. Use LPG or electric cooking rather than wood, coal or dung where possible, keep the kitchen ventilated, and go easy on incense and mosquito coils indoors. On high-AQI days, keep windows closed during peak hours and use an air purifier if you have one.
- Good nutrition. Exclusive breastfeeding for the first six months, then a varied diet, helps protect babies. For adults, a balanced diet with enough protein supports the immune system.
- Manage long-term conditions. Keeping diabetes, asthma, COPD and heart disease well controlled lowers the risk of serious infection.
- Don’t misuse antibiotics. They don’t treat colds or flu, and taking them unnecessarily fuels antibiotic resistance.
Recovering from pneumonia
Most people with mild pneumonia recover at home in a few weeks, though tiredness and a cough can last longer, especially in older adults.
- Finish the full course of any antibiotics you’re prescribed, even if you feel better.
- Rest, drink plenty of fluids and use paracetamol for fever or pain if needed.
- Don’t smoke, and avoid smoky or polluted air while your lungs heal.
- Ease back into activity gradually. Gentle walking and breathing exercises can help.
- Return to the doctor if your breathing gets worse, the fever comes back or doesn’t settle after three days of treatment, or you cough up blood.
The bottom line
This year’s World Pneumonia Day theme, “A New Era of Pneumonia Control”, is a reminder that we already have most of the tools we need. Know the warning signs, especially fast breathing in children and confusion in older adults, and get help early. Make sure your children’s vaccines are up to date, and if you’re over 65 or living with a long-term condition, ask your doctor about pneumococcal and yearly flu vaccines. Cleaner air, no smoking, good nutrition and handwashing do the rest.
Pro Tip: Use the GOQii App to track your activity, sleep and health goals through the winter, and note when your family’s vaccines are next due. Your GOQii Personalised Health Coach can help you build habits that support healthy lungs, from quitting smoking to staying active through the smog season.
Frequently asked questions
What are the first signs of pneumonia?
Common early signs are a cough, fever with chills or sweating, breathing faster or feeling short of breath, chest pain when breathing or coughing, and unusual tiredness. In older adults, confusion or weakness may be the main sign. In children, fast breathing is a key warning sign.
How do I know if my child has pneumonia?
Watch for a cough or cold with fast breathing, counted over a full minute while the child is calm: 50 or more breaths a minute in babies aged 1 to 11 months, or 40 or more in children aged 1 to 5 years. Get urgent help if the lower chest pulls in with each breath, the lips look bluish, or the child can’t drink or is unusually sleepy.
Who is most at risk of pneumonia?
Children under five, adults over 65, smokers, and people with diabetes, asthma, COPD, heart, kidney or liver disease or a weakened immune system are at highest risk. Malnutrition and air pollution also raise the risk.
Which vaccines protect against pneumonia?
Pneumococcal, Hib, measles, influenza and whooping cough vaccines all help prevent pneumonia. In India, babies get the pneumococcal conjugate vaccine free at 6 weeks, 14 weeks and 9 months under the Universal Immunisation Programme. Adults over 65 and those with long-term conditions should ask their doctor about pneumococcal and yearly flu vaccines.
Do adults need the pneumonia vaccine?
Adults over 65, and younger adults with long-term conditions such as diabetes or heart, lung or kidney disease, smokers and people with weakened immunity, are usually advised to have a pneumococcal vaccine. Your doctor will recommend which vaccine and how many doses.
Is pneumonia contagious?
The germs that cause pneumonia, such as bacteria and viruses, can spread from person to person through coughs, sneezes and close contact. Not everyone who catches them develops pneumonia. Handwashing, covering coughs and vaccination reduce the spread.
How long does it take to recover from pneumonia?
Most people with mild pneumonia feel better within one to three weeks with treatment, but tiredness and a cough can last a month or more, particularly in older adults. Finish any prescribed antibiotics and see a doctor if symptoms worsen or don’t improve.
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Disclaimer: The information provided in this blog is for general awareness and educational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalised medical guidance or concerns related to your health.
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