Pneumococcal Vaccination: What Everyone Should Know

Key Facts

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 vaccine or PCV13
• Pneumococcal polysaccharide vaccine or 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.

PCV13

CDC recommends  PCV13 for

• All children younger than 2 years old
• People 2 years or older with certain medical conditions

Adults 65 years or older also can discuss and decide, with their doctor, to get PCV13.

PPSV23

CDC recommends PPSV23 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

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 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. In addition, 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 shot of this vaccine
  • An earlier pneumococcal conjugate vaccine called PCV7 (or Prevnar^®)
  • Any vaccine containing diphtheria toxoid (for example, DTaP)
• Anyone who has had a life-threatening allergic reaction to PPSV23 should not get another shot.
• Anyone with a severe allergy to any part of either 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 2 pneumococcal vaccines licensed for use in the United States by the Food and Drug Administration:

• PCV13 (Prevnar 13^®)
• PPSV23 (Pneumovax23^®)

PCV13

• Prevnar 13^®pdf iconexternal icon: Doctors give this vaccine to children at 2, 4, 6, and 12 through 15 months old. Adults who need this vaccine only get 1 shot. 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.

PPSV23

• Pneumovax23®external icon: Doctors give a single shot of this vaccine to people who need it. CDC recommends 1 or 2 additional shots for people with certain chronic medical conditions. This vaccine helps protect against serious infections caused by 23 types of pneumococcal bacteria.

How Well Do These Vaccines Work?

Summary

Vaccines that help protect against pneumococcal disease work well, but cannot prevent all cases.

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 10 to 17 in 20 healthy adults against invasive pneumococcal disease

* Studies looked at protection against pneumococcal 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. Receiving at least one shot also protected 4 in 5 (81%) children with sickle cell disease, who are at increased risk of pneumococcal disease. The vaccine also prevented antibiotic-resistant pneumococcal infections caused by vaccine serotypes.

Another study showed that receiving at least one shot of PCV13 protects 4 in 5 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.

View Largerimage icon
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, per CDC’s Active Bacterial Core surveillance data.

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 9 in 20 vaccinated against pneumococcal pneumonia caused by vaccine serotypes.

Studies show PPSV23 protects between 10 to 17 in 20 adults with healthy immune systems against invasive disease caused by vaccine serotypes.

 Top of Page

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

PCV13

Mild problems following PCV13 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 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
• 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 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 doctor if you or your child:
  • Feel dizzy
  • Have vision changes
  • Have 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 shots. 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.

 Top of Page

Where Can I Find These Vaccines?

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

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

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

Federally funded health centers can also provide services if you do not have a regular source of health care. Locate one near youexternal icon. 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 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 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. 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).

 Top of Page

References

• Bonten MJ, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adultsexternal icon. 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 studyexternal icon. Lancet Respir Med. 2016;4(5):399–406.
• Pilishvili T, Bennett NM. Pneumococcal disease prevention among adults: Strategies for the use of pneumococcal vaccinesexternal icon. Vaccine. 2015;33(4):D60–5.