Pneumococcal vaccines help protect against bacterial infections caused by Streptococcus pneumoniae (pneumococci). Pneumococcal infections include ear infections, sinusitis, pneumonia, bloodstream infections, and meningitis.
Vaccine Type
There are more than 90 different types of pneumococci. Vaccines are directed against many of the types most likely to cause serious disease.
Two types of pneumococcal vaccines are available: conjugate and polysaccharide.
The conjugate vaccine PCV13 contains protects against 13 types of pneumococci. (This vaccine is used only in certain situations [for example, in adults 65 years and older who do not have a weakened immune system] and is no longer available in the United States or recommended for routine use in children.)
The conjugate vaccine PCV15 protects against 15 types of pneumococci.
The conjugate vaccine PCV20 protects against 20 types of pneumococci.
The conjugate vaccine PCV21 protects against 21 types of pneumococci.
The polysaccharide vaccine PPSV23 protects against 23 types of pneumococci.
Conjugate and polysaccharide vaccines contain a piece of the bacteria that does not cause infection and another specific piece of the bacteria (such as its protein). Because these pieces of the bacteria are harmless, they cannot cause a pneumococcal infection, but they do trigger a strong response from a person's immune system (see Active immunization).
Dose of and Recommendations for Pneumococcal Vaccine
All of the conjugate vaccines are injected into a muscle.
The polysaccharide vaccine is injected under the skin or into a muscle.
Recommendations and the vaccine given depend on the person's age and other factors. (See also Centers for Disease Control and Prevention [CDC]: Pneumococcal Vaccine Recommendations.)
People who should get this vaccine
Pneumococcal vaccine is a routine childhood vaccination. Four doses are given: 1 age 2 months, 1 at age 4 months, 1 at age 6 months, and 1 at age 12 to 15 months. As a routine vaccination, children can be given PCV15 or PCV20. Some children with a weakened or impaired immune system can receive PPSV23 instead. This 4-dose series is for all children under 5 years of age. (See CDC: Recommended Immunizations for Birth Through 6 Years Old, United States, 2025.) Healthy children ages 5 to 18 who have not received a pneumococcal vaccine do not need to be vaccinated unless they have certain medical conditions (such as chronic heart disease, chronic lung disease, diabetes mellitus, cerebrospinal fluid leaks, cochlear implants, and immunocompromising conditions).
People 19 to 49 years old who have certain medical conditions or risk factors (see below), have not previously received a conjugate vaccine, and whose vaccination history is unknown should receive:
1 dose of PCV20 or
1 dose of PCV21 or
1 dose of PCV15 followed by a dose of PPSV23
Medical conditions and risk factors include the following:
Cerebrospinal fluid leak
A weakened immune system (caused by HIV infection, leukemia, lymphoma, or advanced cancer, medications that suppress the immune system [immunosuppressants], and certain organ transplants)
Dysfunctional spleen (including those with sickle cell disease)
Chronic heart, lung (including asthma and emphysema), or liver disorder
People 50 years old and older who have not previously received a conjugate vaccine or whose vaccination history is unknown should receive:
1 dose of PCV20 or
1 dose of PCV21 or
1 dose of PCV15 followed by a dose of PPSV23
For age groups 50 and under, the dose of PPSV23 should be given at least 1 year after the dose of PCV15. However, a minimum of 8 weeks between PCV15 and PPSV23 is sometimes considered for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak.
People 65 years old and older may receive PCV13 after discussing with a health care professional and if they do not have any medical conditions or risk factors. All adults in this age group should receive 1 dose of PPSV23. If the decision is made to give PCV13, it should be given 1 year or more before PPSV23.
People who should not get this vaccine
People who have had a serious, life-threatening allergic reaction (such as an anaphylactic reaction) to any component in the conjugated vaccines PCV13, PCV15, PCV20, and PCV21 or to any vaccine that contains diphtheria toxoid (such as DTaP) should not receive the vaccine.
People who have had an anaphylactic reaction to any component in the PPSV23 vaccine or to a previous dose of the PPSV23 vaccine should not receive it.
If people have a temporary illness, doctors usually wait to give the vaccine until the illness resolves (see also CDC: Who Should NOT Get Vaccinated With These Vaccines?).
Side Effects of Pneumococcal Vaccine
Side effects may include pain and redness at the injection site.
Other side effects include fever, irritability, drowsiness, loss of appetite, and vomiting.
For more information about side effects, see the package inserts.
More Information
The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.
Centers for Disease Control and Prevention (CDC): Pneumococcal conjugate vaccine (interim) information statement
European Centre for Disease Prevention and Control (ECDC): Pneumococcal Disease: Recommended vaccinations
