Pneumococcal Vaccination: What Everyone Should Know
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 recommended to help prevent pneumococcal disease
- Pneumococcal conjugate vaccines (PCVs, specifically PCV15 and PCV20)
- Pneumococcal polysaccharide vaccine (PPSV23)
CDC recommends pneumococcal vaccination for
- All children younger than 5 years old
- People 5 through 64 years old who are at increased risk for pneumococcal disease
- Adults 65 years or older
Below is more information about who should and should not get each type of pneumococcal vaccine.
CDC recommends PCV15 or PCV20 for children younger than 5 years old. Most children receive 4 doses total, 1 dose at each of the following ages:
- 2 months
- 4 months
- 6 months
- 12 through 15 months
Children who started with an earlier PCV called PCV13 can finish with PCV15 or PCV20. There is no need to start over.
Children with Certain Risk Conditions
Certain conditions increase a child’s risk for pneumococcal disease. Children 2 through 18 years old with one of these conditions may need more pneumococcal vaccines. It depends on which pneumococcal vaccines they already received and when. Two examples are provided below:
- Received recommended doses of PCV13 or PCV15, but nothing else: These children can benefit from the extra protection offered by PCV20 or PPSV23.
- PPSV23 is the only pneumococcal vaccine ever received: PCV15 or PCV20 can provide these children important protection.
Talk to a vaccine provider about what is best for your child’s specific situation. They can answer any questions you might have.
Older Adults and Adults with Certain Risk Conditions
CDC recommends PCV15 or PCV20 for adults who never received a PCV and are
- Ages 19 through 64 years with certain risk conditions
- Ages 65 years or older
If PCV15 is used, this should be followed by PPSV23.
Adults who received an earlier PCV (PCV7 or PCV13) should talk with a vaccine provider. They can explain available options to complete the pneumococcal vaccine series.
Adults 65 years or older have the option to get PCV20 if they have already received
- PCV13 (but not PCV15 or PCV20) at any age
- PPSV23 at or after the age of 65 years old
These adults can talk with their doctor and decide, together, whether to get PCV20.
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 the vaccine provider for more information.
Age: Children younger than 2 years old should not get PPSV23.
In addition, tell the person who is giving you or your child a pneumococcal vaccine if:
You or your child has 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 (PCV7, PCV13, PCV15, or PCV20)
- 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. The vaccine provider can tell you about the vaccines’ ingredients.
You or your child is 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. The vaccine provider can advise you.
What Types of Pneumococcal Vaccines Are There?
There are 3 pneumococcal vaccines recommended in the United States:
- PCV15 (Vaxneuvance®)
- PCV20 (Prevnar 20®)
- PPSV23 (Pneumovax23®)
- Prevnar 20®: Vaccine providers give this vaccine to children at 2, 4, 6, and 12 through 15 months old and to older children who need it. Vaccine providers also 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.
- Vaxneuvance®: Vaccine providers give this vaccine to children at 2, 4, 6, and 12 through 15 months old and to older children who need it. Vaccine providers 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.
- Pneumovax23®: Vaccine providers may give this vaccine to children 2 through 18 years old with certain conditions. Vaccine providers also give it to adults who receive PCV15 and may give it to adults who have received an earlier vaccine called PCV13. This vaccine helps protect against serious infections caused by 23 types of pneumococcal bacteria.
Pneumococcal disease rates have decreased dramatically since the United States began using PCVs.
PCV15 and PCV20 are new vaccines, so there are no data on how well these vaccines work in real-world conditions. They were approved based on clinical trial data comparing their safety and immune responses to an earlier vaccine (PCV13).
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 serotypes in the specific vaccine used (also called vaccine serotypes)
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.
United States Started Using PCVs in 2000
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 vaccine serotypes:
- California study: PCV7 protected more than 9 in 10 babies
- CDC study: PCV7 protected nearly all (96%) healthy children
- CDC study: Getting at least one PCV7 shot protected 4 in 5 children with sickle cell disease
Other benefits of PCV7 that were seen in children included fewer
- Ear infections
- Ear tubes placed
- Cases of pneumonia (lung infection)
- Antimicrobial-resistant pneumococcal infections caused by vaccine serotypes
PCV13 Added Protection Against More Serotypes Compared with PCV7
In 2010, FDA licensed PCV13 for children. This vaccine provided protection against infections caused by 6 more serotypes than PCV7. PCV13 caused the body’s immune system to create antibodies, which help fight pneumococcal bacteria, similar to PCV7.
Studies showed PCV13 prevented invasive pneumococcal disease caused by vaccine serotypes:
- Getting at least one PCV13 shot protected 4 in 5 healthy children
- Getting at least one PCV13 shot protected 4 in 5 children with a risk condition
PCV13 also prevented antimicrobial-resistant pneumococcal infections caused by vaccine serotypes.
In 2011, FDA licensed PCV13 for use in adults 50 years or older.
A Netherlands study found the following benefits of PCV13 in adults 65 years or older:
- PCV13 protected 3 in 4 of those vaccinated against invasive pneumococcal disease caused by vaccine serotypes
- PCV13 protected 9 in 20 of those vaccinated against pneumococcal pneumonia caused by vaccine serotypes
PCV15 and PCV20 Were Introduced in Adults First
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 pneumococcal bacteria, similar to PCV13
- Are safe to use compared with PCV13
PCV15 and PCV20 Were Later Introduced in Children
FDA approved PCV15 in 2022 and PCV20 in 2023 for use in children 6 weeks through 17 years old. This was based on clinical trial data showing these vaccines
- Cause the body’s immune system to create antibodies similar to PCV13
- Are safe to use compared with PCV13
PPSV23 Has Been Available Since 1984
Studies show PPSV23 protects between 6 to 7 in 10 adults with healthy immune systems. This protection is against invasive pneumococcal disease caused by serotypes in the vaccine.
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 following PCV15 or PCV20 can include:
- Redness, swelling, pain, or tenderness where the shot was given
- Fever or chills
- Loss of appetite
- Fussiness (irritability)
- Feeling tired
- Muscle aches or joint pain
Mild problems following PPSV23 can include:
- Redness or pain where the shot was given
- Feeling tired
- 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:
- Feels dizzy
- Has vision changes
- Has 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.
A doctor’s office is usually the best place to receive recommended vaccines for you or your child.
Finding Vaccines for Children
Pneumococcal vaccines are 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:
- 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 vaccine providers at future encounters know what vaccines you or your child has already received.
People can pay for pneumococcal vaccines in several ways:
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:
- 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).
- Adamkiewicz TV, Silk BJ, Howgate J, et al. Effectiveness of the 7-valent pneumococcal conjugate vaccine in children with sickle cell disease in the first decade of life. Pediatrics. 2008;121(3):562–9.
- Black S, Shinefield H, Fireman B, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Ped Infect Dis J. 2000;19(3):187–95.
- Black S, Shinefield H, Ling S, et al. Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia. Ped Infect Dis J. 2002;21(9):810–5.
- Bonten MJ, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015;372(12):1114–25.
- Moore MR, Link-Gelles R, Schaffner W, et al. Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease in children in the USA: A matched case-control study. Lancet Respir Med. 2016;4(5):399–406.
- Pilishvili T, Bennett NM. Pneumococcal disease prevention among adults: Strategies for the use of pneumococcal vaccines. Vaccine. 2015;33(4):D60–5.
- CDC’s Active Bacterial Core surveillance (ABCs) Website
- CDC’s Pneumococcal Disease Website
- Educational Materials on Pneumococcal Disease
- Immunization Schedules for Parents and Adults
- Pneumococcal Vaccine Information Statements
- Vaccine Safety
- Pneumococcal Conjugate Vaccine Mandates for Children in Child Care Facilities
Listed by state
- Vaccines for Children Program
- Information for the General Public: Cochlear Implants and Vaccination Recommendations