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Child immunization programs have reported success in decreasing pneumonia mortality: directly in young children and indirectly (herd immunity) in unvaccinated adult populations in some countries. We assess changes in mortality trends for all\u2010cause pneumonia in older adults associated with the introduction of pneumococcal vaccination for children in Peru.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a secondary analysis on administrative data collected periodically by the Peruvian Ministry of Health. An observational retrospective time series analysis was conducted using longitudinal population\u2010based data from death certificates in Peru between 2003 and 2017. The time series includes 6 years before and 9 years after the introduction of the pneumococcal\u2010conjugated vaccines in the national child immunization program in 2009. Monthly frequencies and annual rates for all\u2010cause pneumonia deaths in children under 5 years of age and adults over 65 years of age are presented. Linear and quadratic trends are analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Deaths among older adults accounted for 75.6% of all\u2010cause pneumonia mortality in Peru, with 94.4% of these reporting \u201cpneumonia due to unspecified organism\u201d as the underlying cause of death. Comparing pre\u2010 and post\u2010child immunization program periods, annual average mortality rates from unspecified pneumonia decreased by 22.7% in young children but increased by 19.6% in older adults. A linear trend model supports this overall tendency, but a quadratic curve explains the data better.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pneumococcal\u2010conjugated vaccines are developed using serotypes prevalent in selected countries from less common (invasive) pneumococcal disease and expected to prevent mortality worldwide from widespread (noninvasive) pneumonia. Our results do not support the presence of herd immunity from pneumococcal vaccination of children for community\u2010acquired pneumonia in the increasingly ageing population of Peru. This should direct future research and could influence public health policy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.1224","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T13:11:25Z","timestamp":1683119485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Herd immunity in older adults from a middle\u2010income country: A time\u2010series trend analysis of community\u2010acquired pneumonia mortality 2003\u20132017"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2895-547X","authenticated-orcid":false,"given":"Carlos A.","family":"Sanchez","sequence":"first","affiliation":[{"name":"Universidad Peruana de Ciencias Aplicadas Lima 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