The pneumococcal vaccine offers powerful
protection against illnesses caused by the bacteria
Streptococcus pneumoniae (also known as pneumococcus).
Pneumococcal diseases include three that are serious and even potentially deadly:
pneumonia (lung infection),
meningitis (inflammation of the membranes covering the brain and spinal cord), and blood infections (bacteremia) that can lead to the dangerous inflammatory reaction
sepsis.
The vaccine is meant to protect the people most vulnerable to serious complications, including children, older adults, and people with certain health conditions.
In a recent change, the U.S. Centers for Disease Control and Prevention (CDC) changed its recommendation for routine pneumococcal vaccination from 65 to 50 years old. Certain high-risk individuals should be vaccinated at even younger ages.
Learn more about pneumococcal vaccines, including how to make sense of the various vaccine types and manage any vaccine side effects.
The CDC recommends vaccination to groups that are most vulnerable to complications from pneumococcal infection:
- All children under the age of 5
- All adults age 50 and older
- People ages 5 to 49 years with certain chronic health conditions or other risk factors
Medical issues that warrant pneumococcal vaccination before age 50 include:
- Alcohol use disorder
- Cerebrospinal (around the brain and spinal cord) fluid leak
- Chronic heart, kidney, liver, or lung disease (including COPD, asthma, and emphysema)
- Cigarette smoking
- Cochlear implant (for people with severe hearing loss)
- Diabetes
- Immunocompromising condition
People with the following immunocompromising conditions should be sure to be vaccinated:
- Damaged spleen or having no spleen
- Disease or condition that weakens the immune system
- Disease or condition treated with medicine that weakens the immune system (including cancer and solid organ transplant)
- HIV
- Kidney failure requiring maintenance dialysis or nephrotic syndrome (a kidney disorder)
- Sickle cell disease or other inherited blood disorders
You should not get a pneumococcal vaccine if you have had a life-threatening allergic reaction to that particular vaccine or any ingredient in the vaccine.
The U.S. Department of Health and Human Services advises a conversation with your doctor before getting vaccinated if you:
- Have serious allergies of any kind
- Are pregnant
In general, you can get the vaccination if you’re mildly sick (with a cold, for example), but if you’re moderately or severely ill, you should usually wait until you recover.
There are two types of pneumococcal vaccine: pneumococcal conjugate vaccine (PCVs) and pneumococcal polysaccharide vaccine.
These are the three PCV options that are now most commonly used:
One older PCV vaccine that was widely administered in the past, PCV13, is not considered as useful as the newer PCVs.
There is one polysaccharide vaccine: PPSV23 (Pneumovax 23).
The numbers at the end of these names indicate how many types of pneumococcal bacteria the vaccine protects against.
Children
Children under age 5 get a four-dose PCV vaccine series, with one dose at 2 months, 4 months, 6 months, and 12 to 15 months.
Because most serious pneumococcal infections strike children during their first two years of life, the vaccine will protect them when they are at greatest risk.
The first pneumococcal vaccine for children was introduced in 2000 — whether that protection lasts into older adulthood is yet to be determined.
Adults
Adults typically need one or two pneumococcal shots. Your physician can tell you what pneumonia shots you need based on your age, overall health, risk factors, and prior vaccination history.
The CDC recommends PCV15, PCV20, or PCV21 for eligible adults.
If an older adult has received PCV15, they should get a dose of PPSV23 one year later. If they have never been vaccinated, they can receive either PCV20 or PCV21.
People are urged to get direction from their healthcare provider when it comes to choosing which vaccine to get and staying up-to-date with recommended CDC immunization schedules.
Pneumococcal vaccines are considered very effective at defending against severe disease, hospitalization, and even death, but they cannot prevent all cases.
Since the introduction of PCV vaccines, the rate of pneumococcal infection has fallen by 90 percent in children. Invasive (typically severe) pneumococcal illnesses have dramatically dropped among adults after the U.S. began using PCV in 2000.
The vaccine is considered very safe, and tracking so far has found that the shots produce only minimal side effects.
The shot cannot make you sick with pneumonia because it does not contain live bacteria that can cause the disease — it includes only a small part of the bacteria, which primes your body to develop immunity.
Common issues after vaccination are mild and usually go away within a few days. They include:
- Pain and swelling at the injection site
- Limited movement of the injected arm
- Tiredness
- Headache
- Chills
- Decreased appetite
- Generalized muscle pain and joint pain
Acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) can relieve discomfort after vaccination.
As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction.
Young children may be at a slight increased risk for seizures caused by fever after a pneumococcal conjugate vaccine if it is administered at the same time as an influenza shot. Ask your healthcare provider for more information.
The pneumococcal vaccines are free with most insurance plans and Medicare Part B (medical insurance).
To get some idea of out-of-pocket costs, a study from the National Center for Immunization and Respiratory Diseases found that list prices for PCV20 and PCV21 ranged from $261 to $319 in 2023.
For children not covered by any insurance, the federally funded Vaccines for Children program provides vaccines to children whose parents or guardians may not be able to afford them.
Because pneumococcal vaccination is part of the routine childhood immunization schedule, shots are regularly available at pediatric and family practice offices, community health clinics, and public health departments.
For adults, a healthcare provider's office or pharmacy is usually the best place to get the shots.
