Pneumococcal Vaccine Recommendations
- Routine Vaccination of Infants, Children, and Adults 65 Years or Older
- Vaccination of Older Children and Adults with Certain Indications
- Catch-up Guidance for Healthy Children 4 Months through 4 Years
Below are summaries of recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP). For the full text of the recommendations, see Pneumococcal ACIP Vaccine Recommendations.
Download “PneumoRecs VaxAdvisor” App for Clinicians
This free mobile app gives clinicians patient-specific pneumococcal vaccination recommendations from anywhere at any time.
Routine Vaccination of Infants, Children, and Adults 65 Years or Older
Infants and children
CDC recommends routine administration of pneumococcal conjugate vaccine (PCV13 or PCV15) for all children younger than 2 years of age:
- Give PCV13 or PCV15 to infants as a series of 4 doses, one dose at each of these ages: 2 months, 4 months, 6 months, and 12 through 15 months.
- Children who miss their shots or start the series later should still get vaccinated. The number of doses recommended and the intervals between doses will depend on the child’s age when vaccination begins. See catch-up guidance for additional information.
Adults 65 years or older
CDC recommends routine administration of pneumococcal conjugate vaccine (PCV15 or PCV20) for all adults 65 years or older who have never received any pneumococcal conjugate vaccine or whose previous vaccination history is unknown:
- If PCV15 is used, this should be followed by a dose of PPSV23 one year later. The minimum interval is 8 weeks and can be considered in adults with an immunocompromising condition†, cochlear implant, or cerebrospinal fluid leak.
- If PCV20 is used, a dose of PPSV23 is NOT indicated.
- See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for CDC guidance on vaccination options for adults who have previously received a pneumococcal conjugate vaccine.
Vaccination of Older Children and Adults with Certain Indications
In certain situations, children 2 years or older and adults younger than age 65 should also receive pneumococcal vaccines. See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for all pneumococcal vaccine recommendations by vaccine and age.
Catch-up Guidance for Healthy Children 4 Months through 4 Years
The following “job-aid” provides catch-up guidance for PCV13 or PCV15 for healthy children 4 months through 4 years of age. It includes detailed scenarios by age group and previous number of doses received. This should assist clinicians in interpreting Figure 2 of the Childhood/Adolescent Immunization Catch-up Schedule.
- Pneumococcal Conjugate Vaccine (PCV) Catch-Up Guidance for Healthy Children 4 Months through 4 Years of Age [3 pages]
Options to Complete Vaccination Series for Adults Who Received an Earlier Conjugate Vaccine
PCV13: Adults who received PCV13 have options on how to complete their pneumococcal vaccine series.
- See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for CDC guidance on those vaccination options.
- See Examples: Complete pneumococcal vaccine schedules for adults [4 pages] for a visual illustration of these vaccine options.
PCV7: Treat adults who received PCV7 the same as people who have never received any pneumococcal vaccines.
PCV20 Vaccination for Older Adults Who Completed the Vaccination Series with Earlier Conjugate Vaccines
Based on shared clinical decision-making, adults 65 years or older have the option to get PCV20 if they have received
- PCV13 (but not PCV15 or PCV20) at any age
- PPSV23 at or after the age of 65 years old
See a job-aid on Shared clinical decision-making: Pneumococcal vaccination [1 page] for additional guidance.
Contraindications and Precautions
Do not administer a pneumococcal conjugate vaccine to:
- A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose of PCV7, PCV13, PCV15, or PCV20, or to any vaccine containing diphtheria toxoid
- A person with a severe allergy to any component of these vaccines
Do not administer PPSV23 to:
- A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose
- A person with a severe allergy to any component of this vaccine
Clinicians may administer pneumococcal vaccines, if the provider and parent or patient deems the benefits of vaccination to outweigh the risks, to:
- A person who has a moderate or severe acute illness with or without fever
- ACIP—Vaccines for Children (VFC) Resolutions
- CDC Expert Commentary on Medscape: 5 Things to Know about Pneumococcal Disease and the New Adult Pneumococcal Vaccine Recommendations
- Contraindications and Precautions
- General Best Practice Guidelines for Immunization
- To Pneumococcal Vaccination
From the Pink Book’s “Pneumococcal Disease” chapter
- To Vaccination (General Information)
From the Pink Book’s “General Recommendations on Immunization” chapter
- Guidelines for Vaccinating Pregnant Women
- PneumoRecs VaxAdvisor Mobile App
- Pneumococcal Vaccine Information Statements
- PCV (English / Other Languages)
- PPSV23 (English / Other Languages)
- Standing Orders
From the Immunization Action Coalition
- Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants