DEAR DR. DONOHUE: Please explain the different kinds of pneumonia and what’s covered and not covered by the pneumonia shot. My husband passed away three weeks ago. He was 67. He went to the emergency room because of shortness of breath. He blamed it on his emphysema. In the ER, they put a breathing tube down his throat and said he had pneumonia. They admitted him to the intensive-care unit, where he died three hours later. My husband had the pneumonia shot last year and thought he was protected. What happened? – J.T.

“Pneumonia” means that a part of the lungs is filled with inflammatory fluid. Germs cause most pneumonias, but anything that inflames the lungs can do the same. Toxic gases, for example, cause a chemical pneumonia.

Viruses, bacteria and other infectious agents are responsible for the majority of pneumonias. Bacterial pneumonias are what people think of when they hear the word “pneumonia.” People with this kind of pneumonia have high fever interspersed with shaking chills. They cough and bring up gobs of sputum. Their breathing is rapid and shallow. Many bacteria are capable of causing pneumonia, but the most common kind of bacterial pneumonia is due to the pneumococcus (NEW-moe-KOK-us) germ. Pneumococcal pneumonia used to be one of the greatest killers of older people. The pneumonia shot prevents this kind of pneumonia. The vaccine doesn’t work for any other kind of pneumonia. Antibiotics are effective for most bacterial pneumonias.

Viruses are another cause of pneumonia. Most of the time, viral pneumonia makes a person less sick than does bacterial pneumonia, but not always. As an example of lethal viral pneumonia, the coronavirus was responsible for SARS, the fearsome pneumonia that started out in China and spread to many locations throughout the world in 2003. It caused many deaths and closed down the city of Toronto. There are only a few medicines for viral pneumonia.

Your husband’s lungs were not in the best shape due to his emphysema. That put him in a special class of people, those at high risk of serious pneumonia complications. He must have had one of the other bacteria – not pneumococcus – as a cause of his pneumonia. You have my sincerest condolences.

DEAR DR. DONOHUE: Is it possible to get pneumonia from the pneumonia shot? I have heard of two people who never had pneumonia, but within two months of getting the shot came down with it and had to be hospitalized. Please comment. – J.J.

The pneumonia shot consists of parts of the bacterial coat of the pneumococcus germ. It contains no living germ. It’s impossible to catch pneumonia from the shot.

All people 65 years old and older should get this shot. Half a million people in the United States get pneumococcal pneumonia every year, and close to 7 percent of them die as a result of the infection. That’s a lot of people, and most of those infections and deaths would have been prevented with the pneumonia shot.

People younger than 65 who have diabetes, kidney failure or a defective immune system should also get the shot. Some cancers make people susceptible to pneumococcal pneumonia, and people with those cancers should be immunized. That goes for people without a spleen, too.

DEAR DR. DONOHUE: I have extreme itchiness of my ear canals. It happens day and night. I use a cotton-tipped swab to relieve the itch, which I know you’re not supposed to do. What causes this, and what can be done for the problem? – S.C.

Ear-canal infections, including fungal infections, as well as allergies and eczema can make the ear canal itch. Home remedies for this are not of much value. You have to see the family doctor for a proper diagnosis. Only with that is cure possible.

Seborrheic dermatitis, similar to scalp dandruff, is another cause of canal itch. Cortisporin Otic can usually control this condition.

You really must stop scratching with the cotton-tipped swab or anything else. You’re setting yourself up for major complications by doing so.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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