Pneumococcal Vaccination: What Everyone Should Know

Key Facts

Pneumococcal disease is common in young children, but older adults are at greatest risk of serious illness and death. In the United States, there are 2 kinds of vaccines that help prevent pneumococcal disease

  • Pneumococcal conjugate vaccines (PCV13, PCV15, and PCV20)
  • Pneumococcal polysaccharide vaccine (PPSV23)

Who Should Get Pneumococcal Vaccines?

CDC recommends pneumococcal vaccination for all children younger than 5 years old and all adults 65 years or older. In certain situations, other children and adults should also get pneumococcal vaccines. Below is more information about who should and should not get each type of pneumococcal vaccine.

Talk to your or your child’s doctor about what is best for your specific situation.

PCVs

CDC recommends PCV13 or PCV15 for

  • All children younger than 5 years old
  • Children 5 through 18 years old with certain medical conditions that increase their risk of pneumococcal disease

For those who have never received any pneumococcal conjugate vaccine, CDC recommends PCV15 or PCV20 for

  • Adults 65 years or older
  • Adults 19 through 64 years old with certain medical conditions or other risk factors

PPSV23

CDC recommends PPSV23 for

  • Children 2 through 18 years old with certain medical conditions that increase their risk of pneumococcal disease
  • Adults 19 years or older who receive PCV15

Who Might Not Be Able to Get These Vaccines?

Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below specific to pneumococcal vaccines and ask your or your child’s doctor for more information.

  • Children younger than 2 years old should not get PPSV23.
  • Anyone younger than 19 years old should not get PCV20.

In addition, tell the person who is giving you or your child a pneumococcal vaccine if:

You or your child have had an allergic reaction to an earlier pneumococcal shot or have any severe, life-threatening allergies.

  • Do not get a PCV shot if you have ever had a severe allergic reaction after
    • Any type of PCV (PCV13, PCV15, PCV20, or an earlier vaccine known as PCV7)
    • Any vaccine containing diphtheria toxoid (for example, DTaP)
  • Do not get a PPSV23 shot if you have ever had a severe allergic reaction to that vaccine.
  • Anyone with a severe, life-threatening allergy to any part of these vaccines should not get that vaccine. Your or your child’s doctor can tell you about the vaccines’ ingredients.

You or your child are not feeling well.

  • People who have a mild illness, such as a cold, can probably get vaccinated. People who have a more serious illness should probably wait until they recover. Your or your child’s doctor can advise you.

What Types of Pneumococcal Vaccines Are There?

There are 4 pneumococcal vaccines licensed for use in the United States by the Food and Drug Administration:

  • PCV13 (Prevnar 13®)
  • PCV15 (Vaxneuvance®)
  • PCV20 (Prevnar 20®)
  • PPSV23 (Pneumovax23®)

PCVs

  • Prevnar 13®: Doctors give this vaccine to children at 2, 4, 6, and 12 through 15 months old and to older children who need it. The vaccine helps protect against 13 types of pneumococcal bacteria that can cause serious infections in children and adults.
  • Vaxneuvance®: Doctors give this vaccine to children at 2, 4, 6, and 12 through 15 months old and to older children who need it. Doctors also give this vaccine to adults 65 years or older and other adults who need it. This vaccine helps protect against 15 types of pneumococcal bacteria that commonly cause serious infections in adults.
  • Prevnar 20®: Doctors give this vaccine to adults 65 years or older and other adults who need it. The vaccine helps protect against 20 types of pneumococcal bacteria that commonly cause serious infections in adults.

PPSV23

  • Pneumovax23®: Doctors give this vaccine to children 2 through 18 years old who need it. Doctors also give it to adults who receive PCV15 or who have received PCV13. This vaccine helps protect against serious infections caused by 23 types of pneumococcal bacteria.

How Well Do These Vaccines Work?

Summary

PCV15 and PCV20 are new vaccines, so there are no data on how well these vaccines work in real-world conditions. However, these vaccines were approved because clinical trial data indicate they cause an immune response similar to PCV13, which has been shown to protect against serious pneumococcal infections.

Studies* show that getting at least 1 shot of PCV13 protects:

  • At least 8 in 10 babies from serious infections called invasive pneumococcal disease
  • 3 in 4 adults 65 years or older against invasive pneumococcal disease
  • 9 in 20 adults 65 years or older against pneumococcal pneumonia

Studies* show that getting 1 shot of PPSV23 protects:

  • Between 6 to 7 in 10 healthy adults against invasive pneumococcal disease

* Studies looked at protection against pneumococcal infections caused by the serotypes covered by the specific vaccine used

Some pneumococcal infections are “invasive.” Invasive disease means that germs invade parts of the body, such as blood, that are normally free from germs. Invasive disease is usually very serious and can sometimes result in death.

Vaccines that help protect against pneumococcal disease work well but cannot prevent all cases.

In Depth

The Food and Drug Administration (FDA) licensed the first pneumococcal conjugate vaccine (PCV7 or Prevnar®) in 2000. That same year, the United States began using PCV7 routinely in children. It provided protection against infections caused by 7 types (serotypes) of pneumococcal bacteria. Studies showed PCV7 was highly effective in preventing invasive pneumococcal disease caused by serotypes included in the vaccine (vaccine serotypes) in young children.

In 2010, FDA licensed PCV13, which provides protection against infections caused by 6 more serotypes than PCV7. Studies show PCV13 causes the body’s immune system to create antibodies, which help fight the pneumococcal bacteria, similar to PCV7.

In a California study, PCV7 protected more than 9 in 10 babies from invasive disease caused by vaccine serotypes. The children who got the vaccine also had fewer ear infections and fewer ear tubes placed. The study also showed the vaccine prevented pneumonia in children.

A CDC study found PCV7 protected nearly all (96%) healthy children against pneumococcal disease caused by vaccine serotypes. Receiving at least one shot also protected 4 in 5 (81%) children with sickle cell disease, who are at increased risk of pneumococcal disease. The vaccine also prevented antibiotic-resistant pneumococcal infections caused by vaccine serotypes.

Another study showed that receiving at least one shot of PCV13 protects 4 in 5 babies from invasive disease caused by vaccine serotypes. This protection was similar among children with and without medical conditions that put them at increased risk of pneumococcal disease. The vaccine is also effective at preventing antibiotic-resistant pneumococcal infections caused by vaccine serotypes.

Trends in invasive pneumococcal disease among children aged <5 years old, 1998-2016.

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The United States saw large drops in rates of invasive pneumococcal disease caused by serotypes included in pneumococcal vaccines (PCV7 and PCV13) after routine use of the vaccines began for children, per CDC’s Active Bacterial Core surveillance data.

Rates of invasive pneumococcal disease caused by the serotypes in PCV7 declined by 99% in the United States since 2000. Unvaccinated people of all ages, including babies too young to get the vaccine, have seen decreases in disease. Since it helps protect unvaccinated people, this shows the vaccine decreased the bacteria’s spread in the community. Rates of invasive pneumococcal disease caused by some serotypes not in PCV7 increased between 2000 and 2010. However, these increases were small compared to the decreases in serotypes in the vaccine. Also, PCV13 covers the main serotypes that caused the increases. Thus, rates of disease caused by these serotypes declined once PCV13 replaced PCV7 in 2010. Experts estimate PCV13 prevented more than 30,000 cases of invasive pneumococcal disease and 3,000 deaths in its first 3 years of use.

In 2011, FDA licensed PCV13 for use in adults 50 years or older. A study in the Netherlands included approximately 85,000 adults 65 years or older. In this study, PCV13 protected 3 in 4 of those vaccinated against invasive pneumococcal disease caused by vaccine serotypes. PCV13 also protected 9 in 20 vaccinated against pneumococcal pneumonia caused by vaccine serotypes.

In 2021, FDA licensed PCV15 and PCV20 for use in adults 18 years or older. Clinical trial data show PCV15 and PCV20

  • Cause the body’s immune system to create antibodies, which help fight the pneumococcal bacteria, similar to PCV13
  • Are safe to use compared with PCV13

In 2022, FDA licensed PCV15 for use in children 6 weeks through 17 years old. This was based on clinical trial data showing PCV15

  • Causes the body’s immune system to create antibodies similar to PCV13
  • Is safe to use compared with PCV13

Studies show PPSV23 protects between 6 to 7 in 10 adults with healthy immune systems against invasive disease caused by vaccine serotypes.

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What Are the Possible Side Effects?

Most people who get a pneumococcal vaccine do not have any serious problems with it. With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own within a few days, but serious reactions are possible.

Mild Problems

PCVs

Mild problems following PCV13, PCV15, or PCV20 can include:

  • Reactions where the shot was given
    • Redness
    • Swelling
    • Pain or tenderness
  • Fever
  • Loss of appetite
  • Fussiness (irritability)
  • Feeling tired
  • Headache
  • Muscle aches or joint pain
  • Chills

Young children who get PCV13 at the same time as inactivated flu vaccine may be at increased risk for seizures caused by fever. At this time, data are not available on if the same risk is true if PCV15 is given at the same time as an inactivated flu vaccine. Ask your doctor for more information.

PPSV23

Mild problems following PPSV23 can include:

  • Reactions where the shot was given
    • Redness
    • Pain
  • Feeling tired
  • Fever
  • Muscle aches

If these problems occur, they usually go away within about 2 days.

Problems that Could Happen After Getting Any Injected Vaccine

  • People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your doctor if you or your child:
    • Feel dizzy
    • Have vision changes
    • Have ringing in the ears
  • As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

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Where Can I Find These Vaccines?

Your doctor’s office is usually the best place to receive recommended vaccines for you or your child.

Finding vaccines for children

PCV13 and PCV15 are part of the routine childhood immunization schedule. Therefore, at least one of these vaccines is regularly available for children at:

  • Pediatric and family practice offices
  • Community health clinics
  • Public health departments

Finding vaccines for adults

If your doctor does not have pneumococcal vaccines for adults, ask for a referral.

Pneumococcal vaccines may also be available for adults at:

  • Pharmacies
  • Workplaces
  • Community health clinics
  • Health departments
  • Other community locations, such as schools and religious centers

You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.

Recording your vaccination

When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps doctors at future encounters know what vaccines you or your child have already received.

How Do I Pay for These Vaccines?

People can pay for pneumococcal vaccines in several ways:

Medicare

Medicare Part B covers 100% of the cost for two different pneumococcal vaccines (when administered at least 12 months apart).

Private Health Insurance

Most private health insurance plans cover pneumococcal vaccines. Check with your insurance provider for details on whether there is any cost to you. Ask your insurance provider and for a list of in-network vaccine providers.

Vaccines for Children Program

The Vaccines for Children (VFC) Program provides vaccines to children whose parents or guardians may not be able to afford them. A child is eligible if they are younger than 19 years old and meets one of the following requirements:

  • Medicaid-eligible
  • Uninsured
  • American Indian or Alaska Native
  • Underinsured (have health insurance that does not cover vaccines or does not cover certain vaccines)

If your child is VFC-eligible, ask if your doctor is a VFC provider. For help in finding a VFC provider near you, contact your state or local health department’s VFC Program Coordinator or call CDC at 1-800-CDC-INFO (232-4636).

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Page last reviewed: January 24, 2022