Key points
- CDC recommends pneumococcal vaccination for children younger than 5 years and adults 65 years or older.
- CDC also recommends pneumococcal vaccination for children and adults at increased risk for pneumococcal disease.
- Follow the recommended immunization schedule to ensure that your patients get the pneumococcal vaccines that they need.
Background
App available to interpret recommendations
The United States uses 2 types of pneumococcal vaccines. Each individual vaccine helps protect against different serotypes of pneumococcal bacteria.
- Pneumococcal conjugate vaccines (PCVs)
- PCV15
- PCV20
- PCV21
- PCV15
- Pneumococcal polysaccharide vaccine
- PPSV23
- PPSV23
The following summarizes CDC's current age- and risk-based pneumococcal vaccine recommendations. Access the official, full text of CDC's current and historical pneumococcal vaccine recommendations.
Infants and children
Routine vaccination
CDC recommends routine pneumococcal vaccination for all children younger than 5 years old.
Administer a 4-dose PCV series (PCV15 or PCV20), 1 dose at each of the following ages:
- 2 months
- 4 months
- 6 months
- 12 through 15 months
Catch-up guidance
Vaccinate children younger than 5 years of age who miss their shots or start the series later than recommended. The number of doses recommended and the intervals between doses will depend on the child's age when vaccination begins.
Job aid for simplifying PCV catch-up
Adults 65 years or older
Routine vaccination
Administer PCV15, PCV20, or PCV21 for all adults 65 years or older
- Who have never received any pneumococcal conjugate vaccine
- Whose previous vaccination history is unknown
PCV15: Additional vaccination needed
If PCV15 is used, administer a dose of PPSV23 Aone year later, if neededB. Their pneumococcal vaccinations are complete.
The minimum interval is 8 weeks and can be considered in adults with:
- An immunocompromising condition
- A cochlear implant
- A cerebrospinal fluid leak
PCV20 or PCV21: Additional vaccination not recommended
If PCV20 or PCV21 is used, a dose of PPSV23 isn't indicated. Regardless of which vaccine is used (PCV20 or PCV21), their pneumococcal vaccinations are complete.
Recommendation for shared clinical decision-making
Based on shared clinical decision-making, adults 65 years or older have the option to get PCV20 or PCV21, or to not get additional pneumococcal vaccines. They can get PCV20 or PCV21 if they have received both
- PCV13 (but not PCV15, PCV20, or PCV21) at any age and
- PPSV23 at or after the age of 65 years old
Job aids for adult pneumococcal vaccination
Shared clinical decision-making: This job aid should assist vaccine providers in discussions with older adults considering PCV20 or PCV21 vaccination.
Vaccine timing for adults: This job aid should help vaccine providers interpret adult pneumococcal vaccine recommendations.
Risk-based recommendations
In certain situations, children 2 through 18 years of age may need additional pneumococcal vaccine doses. In addition, adults younger than age 65 years of age may be recommended to receive pneumococcal vaccines.
Risk-based indications for pneumococcal vaccination vary by patient age. The type of vaccine and number of doses can also vary by age and vaccination history.
Resources
Contraindications and precautions
General Best Practice Guidelines for Immunization
Pink Book chapter on pneumococcal disease
Immunization schedules
Child and adolescent immunization schedule
Pneumococcal Vaccine Information Statements
PCV: English | Other languages
PPSV23: English | Other languages
- If PPSV23 is not available, one dose of PCV20 or PCV21 may be given.
- Only one dose of PPSV23 is indicated. If previously administered, another dose isn't needed.