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Pneumococcal Vaccination: What Everyone Should Know

One of the Recommended Vaccines by Disease

Key Facts

Pneumococcal disease is common in young children, but older adults are at greatest risk of serious illness and death. There are two kinds of vaccines that help prevent pneumococcal disease.

 

Who Should Get Pneumococcal Vaccines?

CDC recommends pneumococcal vaccination for all children younger than 2 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 healthcare professional about what is best for your specific situation.

Pneumococcal Conjugate Vaccine

CDC recommends vaccination with the pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) for

  • All children younger than 2 years old
  • All adults 65 years or older
  • People 2 through 64 years old with certain medical conditions

Pneumococcal Polysaccharide Vaccine

CDC recommends vaccination with the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®) for

  • All adults 65 years or older
  • People 2 through 64 years old with certain medical conditions
  • Adults 19 through 64 years old who smoke cigarettes

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Who Should Not 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 and ask your or your child’s healthcare professional for more information.

Pneumococcal Conjugate Vaccine

Tell the person who is giving you or your child a pneumococcal conjugate vaccine if:

You or your child have had a life-threatening allergic reaction or have a severe allergy.

  • Anyone who has had a life-threatening allergic reaction to any of the following should not get PCV13:
    • A dose of this vaccine
    • An earlier pneumococcal conjugate vaccine called PCV7 (or Prevnar®)
    • Any vaccine containing diphtheria toxoid (for example, DTaP)
  • Anyone with a severe allergy to any component of PCV13 should not get the vaccine. Your or your child’s healthcare professional can tell you about the vaccine’s components.

You or your child are not feeling well.

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

Pneumococcal Polysaccharide Vaccine

Children younger than 2 years old should not get this vaccine. In addition, tell the person who is giving you or your child a pneumococcal polysaccharide vaccine if:

You or your child have had a life-threatening allergic reaction or have a severe allergy.

  • Anyone who has had a life-threatening allergic reaction to PPSV23 should not get another dose.
  • Anyone who has a severe allergy to any component of PPSV23 should not get it. Your or your child’s healthcare professional can tell you about the vaccine’s components.

You or your child are not feeling well.

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

You are pregnant.

  • There is no evidence that PPSV23 is harmful either to a pregnant woman or to her baby. However, as a precaution, women who need the vaccine should get it before becoming pregnant, if possible.

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What Types of Pneumococcal Vaccines Are There?

There are two pneumococcal vaccines licensed for use in the United States by the Food and Drug Administration (FDA):

  • Pneumococcal conjugate vaccine (PCV13 or Prevnar 13®)
  • Pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®)

Helpful Terms

  • Conjugate: A type of vaccine that joins a protein to part of the bacteria to improve the protection the vaccine provides
  • Polysaccharide: A type of vaccine that is made to look like the surface of certain bacteria in order to help the body build protection against that germ

Pneumococcal Conjugate Vaccine

  • Prevnar 13® [42 pages]: Doctors give this vaccine to children at 2, 4, 6, and 12 through 15 months old. Adults who need this vaccine only get a single dose. The vaccine helps protect against the 13 types of pneumococcal bacteria that most commonly cause serious infections in children and adults. It can also help prevent ear infections and pneumonia caused by those 13 types of pneumococcal bacteria.

Pneumococcal Polysaccharide Vaccine

  • Pneumovax23® [9 pages]: Doctors give a single dose of this vaccine to people who need it. CDC recommends one or two additional doses for people with certain chronic medical conditions. This vaccine helps protect against serious infections caused by 23 types of pneumococcal bacteria.

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How Well Do These Vaccines Work?

Summary

Some pneumococcal infections are “invasive.” Invasive disease means that germs invade parts of the body 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.

Studies* show that at least 1 dose of pneumococcal conjugate vaccine protects

  • At least 8 in 10 babies from serious infections called invasive pneumococcal disease
  • 75 in 100 adults 65 years or older against invasive pneumococcal disease
  • 45 in 100 adults 65 years or older against pneumococcal pneumonia

Studies* show that 1 dose of pneumococcal polysaccharide vaccine protects

  • Between 50 to 85 in 100 healthy adults against invasive pneumococcal disease

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

 

 

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. One dose also protected 8 in 10 (81%) children with medical conditions that increased their risk of pneumococcal disease. The vaccine also prevented   antibiotic-resistant pneumococcal infections caused by vaccine serotypes.

Another study showed one dose of PCV13 protects 8 in 10 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.

PCV13 trends chart

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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.

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 45 in 100 vaccinated against pneumococcal pneumonia caused by vaccine serotypes.

Studies show PPSV23 protects between 50 to 85 in 100 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

Pneumococcal Conjugate Vaccine

Mild problems following pneumococcal conjugate vaccination can include:

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

Young children who get pneumococcal conjugate vaccine at the same time as inactivated flu vaccine may be at increased risk for seizures caused by fever. Ask your doctor for more information.

Pneumococcal Polysaccharide Vaccine

Mild problems following pneumococcal polysaccharide vaccination can include:

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

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

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Problems that Could Happen After Getting Any Injected Vaccine

  • People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your healthcare professional if you or your child:
    • Feels dizzy
    • Has vision changes
    • Has ringing in the ears
  • Some people get severe pain in the shoulder and have difficulty moving the arm where the doctor gave the shot. This happens very rarely.
  • Any medicine can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million doses. These types of reactions would happen within a few minutes to a few hours after the vaccination.
  • As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

For more information on possible side effects, visit CDC’s Possible Side-effects from Vaccines webpage.

 

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Where Can I Find These Vaccines?

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

Pneumococcal conjugate vaccine is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:

  • Pediatric offices
  • Family practice offices
  • Community health clinics
  • Public health departments

If your healthcare professional 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

Federally funded health centers can also provide services if you don’t have a regular source of health care. Locate one near you. You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.

When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps healthcare professionals know what vaccines you or your child has already received.

 

How Do I Pay for These Vaccines?

There are several ways to cover the cost of pneumococcal vaccines:

Medicare

Medicare Part B covers 100% of the cost for both 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 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 healthcare professional 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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References

 

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