Vaccines help prevent pneumococcal disease, which is any type of illness caused by Streptococcus pneumoniae bacteria. There are two kinds of pneumococcal vaccines recommended in the United States:

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

Childhood recommendations

CDC recommends PCV15 or PCV20 for children younger than 5 years old.

Children 2 through 18 years old with certain risk conditions may need more pneumococcal vaccines. It depends on which pneumococcal vaccines they already received and when.

Talk with a vaccine provider if you have questions about pneumococcal vaccines.

Adult recommendations

CDC recommends PCV15 or PCV20 for adults who never received a PCV and are

• Ages 65 years or older
• Ages 19 through 64 years old with certain risk conditions

If PCV15 is used, it should be followed by a dose of PPSV23.

Adults who received an earlier PCV (PCV7 or PCV13) should talk with a vaccine provider. The provider 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 AND
• PPSV23 at or after the age of 65 years old

These adults can talk with a vaccine provider and decide, together, whether to get PCV20.

What Everyone Should KnowInformation for Healthcare Professionals

CDC recommends PCV15 or PCV20 for:

• Children younger than 5 years old
• People 5 through 64 years old with certain risk conditions who never received a PCV
• Adults 65 years or older who never received a PCV

CDC recommends PPSV23 for:

• Children 2 through 18 years old with certain risk conditions who get PCV15
• Adults 19 years or older who get PCV15

People previously recommended to get both PCV13 and PPSV23 who already received PCV13 can complete the recommended series with:

• PCV20
  OR
• PPSV23

Many adults may be at increased risk for pneumococcal disease and not know it. Two vaccines provide protection against this serious and sometimes deadly disease. Talk to your clinician to make sure you are up to date on these and other recommended vaccines.

Each year in the United States, pneumococcal disease kills thousands of adults. Thousands more end up in the hospital because of pneumococcal disease. It can cause severe infections of the lungs (pneumonia), bloodstream (bacteremia), and lining of the brain and spinal cord (meningitis). Vaccines are the best way to prevent pneumococcal disease.

Two vaccines help prevent pneumococcal disease:

• PCV13 (pneumococcal conjugate vaccine)
• PPSV23 (pneumococcal polysaccharide vaccine)

PCV13 protects against 13 strains of pneumococcal bacteria and PPSV23 protects against 23 strains of pneumococcal bacteria. Both vaccines provide protection against illnesses like meningitis and bacteremia. PCV13 also provides protection against pneumonia.

Which Adults Should and Shouldn’t Get PCV13?

CDC recommends PCV13 for:

• All adults 65 years or older
• Adults 19 years or older with certain health conditions

Don’t get PCV13 if you have ever had a life-threatening allergic reaction to:

• A shot of the vaccine
• An earlier pneumococcal vaccine called PCV7 (or Prevnar)
• Any vaccine containing diphtheria toxoid (for example, DTaP)

In addition, anyone with a severe allergy to any component of PCV13 should not get the vaccine.

Which Adults Should and Shouldn’t Get PPSV23?

CDC recommends PPSV23 for:

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

Don’t get PPSV23 if you:

• Ever had a life-threatening allergic reaction to a shot of PPSV23
• Have a severe allergy to any component of the vaccine

Pneumococcal Vaccines Are Safe

These vaccines are safe, but side effects can occur. Most side effects are mild, such as arm swelling or soreness, and do not affect daily activities.

You Shouldn’t Get Both Pneumococcal Vaccines at the Same Time

CDC recommends against getting PCV13 and PPSV23 at the same time. If you need both vaccines, get PCV13 first, followed by a shot of PPSV23 at another visit. Talk with your healthcare professional to find out when you should come back for the second vaccine.

You Can Get Influenza and Either Pneumococcal Vaccine at the Same Time

You can get either pneumococcal vaccine (but not both) when you get the influenza (flu) vaccine. While you don’t need a pneumococcal vaccine every year, it is important to get a flu vaccine each flu season. Having the flu increases your risk of getting pneumococcal disease.

There Are Several Ways to Cover the Cost of Pneumococcal Vaccines

Most private health insurance policies 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. Medicare Part B also covers 100% of the cost for both pneumococcal vaccines (when administered at least 1 year apart).

Pneumococcal Disease Can Cause Both Mild and Serious Infections

Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, also known as pneumococcus. Pneumococcal bacteria can cause many types of illnesses that range from mild to very severe. When pneumococcal bacteria spread from the nose and throat to ears or sinuses, it generally causes mild infections. When the bacteria spread into other parts of the body, it can lead to severe health problems (pneumonia, bacteremia, and meningitis).

These illnesses can be deadly, especially for:

• Adults 65 years or older
• People with chronic health conditions
• People whose immune systems are weakened by disease or medicine (immunocompromised)

Pneumococcal disease can lead to disabilities like deafness, brain damage, or loss of arms or legs.

Pneumococcal Disease Is Contagious

Pneumococcal bacteria spread from person to person through coughing, sneezing, and close contact. People can carry the bacteria in their nose and throat without being sick and spread the bacteria to others.

Four doses of a pneumococcal shot (PCV13 or PCV15) are recommended for children by doctors as the best way to protect against pneumococcal disease.

When should my child get a pneumococcal shot?

One dose at each of the following ages:

• 2 months
• 4 months
• 6 months
• 12 – 15 months

Why should my child get a pneumococcal shot?

• Protects your child from against potentially serious, and even deadly infections cause by pneumococcal disease, like pneumococcal meningitis (infection of the tissue covering the brain and spinal cord) and pneumonia (lung infection).
• Keeps your child from missing school or child care and you from missing work.

Pneumococcal shots are safe.

Pneumococcal shots are safe and effective at preventing pneumococcal disease. Vaccines like any medicine, can have side effects. These are usually mild and go away on their own.

What types of pneumococcal vaccines are there?

All babies and young children should receive a pneumococcal conjugate vaccine (PCV13 or PCV15). Some children with medical conditions that increase their risk of pneumococcal disease should also receive the pneumococcal polysaccharide vaccine (PPSV23). The number of doses depends on the medical condition. Talk to your child’s doctor about which vaccines they recommend.

What are the side effects?

Most children don’t have any side effects from the shot. The side effects that do occur are usually mild, and may include:

• Fussiness
• Feeling tired
• Loss of appetite (not want to eat)
• Redness, swelling, or soreness where the shot was given
• Fever or chills
• Headache
• Muscle aches or joint pain

Prepare for your child's vaccine visit and learn about how you can:

• Research vaccines and ready your child before the visit
• Comfort your child during the appointment
• Care for your child after the shot

What is pneumococcal disease?

Pneumococcal disease can cause infections of the ears, lungs, blood, and brain.

Pneumococcal disease is an illness caused by bacteria called pneumococcus. It is often mild, but can cause serious symptoms, lifelong disability, or death. Children younger than 2 years old are among those most at risk for the disease.

Treatment with penicillin and other drugs is not as effective as it used to be, because some strains of the disease have become resistant to these drugs. This makes prevention of the disease, through vaccination, even more important.

What are the symptoms?

There are many types of pneumococcal disease. Symptoms depend on the part of the body it affects.

Is it serious?

Pneumococcal disease ranges from mild to very dangerous. About 2,000 cases of serious disease (bacteremia, pneumonia with bacteremia, and meningitis) occur each year in children under 5 years old in the United States. These illnesses can lead to disabilities like deafness, brain damage, or loss of arms or legs. About 1 out of 12 children who get pneumococcal meningitis dies.

How is it spread?

Pneumococcal disease spreads when an infected person coughs or sneezes. Some children may not even feel sick, but they could have the bacteria in their noses and throats. These children can still spread pneumococcal disease.

Do children in the United States still get pneumococcal disease?

Yes. Each year in the United States, pneumococcal disease causes thousands of cases of pneumonia and ear infections. Without vaccines, there would be many more cases. Among children, those younger than 2 years old are most likely to have a serious case of pneumococcal disease.

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 2 years old and all adults 65 years or older. In certain situations, older children and other 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 for

• All children younger than 2 years old
• Children 2 through 18 years old with certain medical conditions

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
• 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 PCV15 or 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 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.

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. 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.

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 is part of the routine childhood immunization schedule. Therefore, it 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).