The Kathmandu Metropolitan City (KMC) has started administering the pneumonia vaccine to elderly residents with underlying conditions, who face heightened risk of lung infection in winter.

Officials at the Health Department under the city office said that 1,900 people have already been inoculated and an additional 3,500 will be administered with the vaccine in the coming days.

“We have been administering pneumonia vaccines to elderly people above 75 years of age,” said Deepak Kumar KC, chief of the department. “Those above 75 with underlying conditions like cancer, and renal disease, among others, are highly vulnerable to severe pneumonia during the winter season.”

Pneumonia, an infection of the lungs caused by various types of bacteria, viruses and fungi, is the leading cause of morbidity in Nepal from which thousands of people from across the country get affected. It is also the number one killer of children under five in the country.

It kills more children annually than malaria, tuberculosis and HIV combined.

Viruses that cause influenza are highly contagious, which spread quickly in communities and affect the lungs of those who are infected. These diseases can cause fever, cough, body aches, and sometimes vomiting and diarrhoea, as well as pneumonia. If left untreated, they can lead to death. Pneumonia caused by bacteria is even deadlier than that caused by viruses, and children under five and people above 65 years of age are highly vulnerable to the disease, experts say.

Officials at the city office say that elderly people, who generally have multiple comorbidities, are highly vulnerable to complications if they suffer from pneumonia. They say many elderly people do not seek pneumonia shots on their own, as the vaccine is costly, and many families don’t think it necessary to purchase vaccines for their vulnerable parents, even if they can afford to do so.

“We have been providing Pfizer’s pneumonia vaccine to elderly people, which cost over Rs5000, and the budget for the vaccine is our own [KMC’s],” said KC.

Officials say the vaccine is being administered only to residents of the city.

Of late, major hospitals in the Kathmandu Valley have reported a surge in influenza cases.

Doctors say administering vulnerable populations with pneumonia and updated influenza shots at the time of season change reduces the risk of severe illness and death.

They say that multiple respiratory viruses that cause seasonal influenza—A(H1N1), A(H3), influenza B, rhinovirus, and adenovirus—become active during season change and winter and infect thousands of people.

Seasonal influenza is also highly contagious. It mainly affects the lungs and quickly spreads in communities. If seasonal influenza is left untreated, it can cause pneumonia, which can be fatal, according to experts.

“Decision to administer pneumonia vaccine to elderly population is a very positive one,” said Dr Sher Bahadur Pun, chief of Clinical Research Unit at the Sukraraj Tropical and Infectious Disease Hospital. “Other local governments should follow KMC’s move and administer vulnerable populations with pneumonia vaccines.”

Doctors say family members of elderly people should buy influenza and pneumonia vaccines for their parents, as this reduces the risk of severe illness from viral and bacterial infections that can lead to pneumonia. They say elderly people and those with underlying health conditions—heart disease, renal problems, cancer, and diabetes, among others—are particularly vulnerable.

The government has included pneumonia vaccine in its routine immunisation list of children and provides it free of cost from state-run health facilities. But elderly people and others have to purchase it (which costs over Rs5,000) themselves if they need to be vaccinated.

Public health measures—mask-wearing, handwashing, avoiding crowds, and maintaining social distancing—can reduce infection, doctors say.