Just saw my primary care doctor, who offered clarification. If you are over 65, you are not actively battling a lung condition, and your natural immunity is strong, doctors might not push the pneumonia vaccine. She thinks that my bronchiecstasis is in check and that my immune system is strong enough to get me through pneumonia. Doctors should be making their recommendations on a patient-by patient-basis, not one size fits all. With respect to the confusion in my pulmonologist's office, she concurred with my assessment that there are too many elderly patients and not enough doctors in Florida, so all of the good ones, at the least, are swamped.