What Is the Pneumococcal Vaccine?
Pneumococcal disease can cause serious respiratory (breathing) problems for very young children and older adults. To help prevent this, there are four pneumococcal conjugate vaccines (PCVs) available. Conjugate vaccines are a type of vaccine created to enhance the immune response, which means your body’s defense system will work better to fight off threats. These PCVs are:
- PCV13
- PCV15
- PCV20
- PCV21
The numbers refer to the number of strains or types of pneumococcal bacteria the vaccines target.
An older type of vaccine called pneumococcal polysaccharide vaccine 23 (PPSV23) is given to children older than 2 in certain cases and adults who already have been given PCV15. Unlike PCVs, PPSV23 doesn't target your immune system in your nasal passages (nose) but protects against more serious complications.
Pneumococcal vaccine for babies and young children
PCV15 and PCV20 are safe for children under 5, with doses given at 2 months, 4 months, 6 months, and 12-15 months. Infants and very young children are at higher risk for several dangerous infections, including pneumonia and bacterial meningitis.
Pneumococcal vaccine for children
Children over 5 who weren't fully immunized against pneumococcal bacteria earlier or who have certain medical conditions (such as chronic kidney disease) can be given the PCV13, PCV15, PCV20, or PPSV23 vaccines. The schedule depends on how many (if any) pneumococcal shots your child had before and any medical conditions they may have.
What Is Pneumococcal Disease?
Pneumococcal disease is an infection caused by the bacteria Streptococcus pneumoniae or pneumococcus. People can be infected with the bacteria, or they can carry it in their throats and not be ill. Those carriers can still spread it, primarily in droplets from their nose or mouth when they breathe, cough, or sneeze.
What does the pneumococcal vaccine prevent?
The pneumococcal vaccine helps prevent several pneumococcal diseases caused by the Streptococcus pneumoniae, including:
- Bacterial meningitis, an infection of the covering of the brain and spinal cord that can lead to confusion, coma, death, and other physical effects, such as blindness or paralysis
- Pneumonia, an infection of your lungs that leads to cough, fever, and difficulty breathing
- Otitis media, a middle ear infection that can cause pain, swelling, sleeplessness, fever, and irritability
- Bacteremia, a dangerous infection in your bloodstream
- Sinus infections
There are more than 3,500 deaths each year in the U.S. as a result of pneumococcal disease. More than half of those deaths are in adults who should have been vaccinated, according to the CDC.
Worldwide, pneumonia is the leading cause of death in children under 5 and the most common reason for children to be hospitalized in the U.S. After the launch of PCVs in 2000, rates of pneumococcal diseases began falling dramatically in children and adults.
Are Both Pneumococcal Vaccines Safe?
Both the PCV and PPSV vaccines are safe. As with any medicine, there's always the possibility of a serious problem, such as an allergic reaction. But the risk of serious harm or death is very small.
In studies involving nearly 60,000 doses of the PCV vaccine, there were no moderate or severe reactions. The mild side effects included:
- Redness, tenderness, or swelling where the shot was given in about 1 out of every 4 infants
- Fever higher than 100.4 F in about 1 out of every 3 infants
- Fever higher than 102.2 F in about 1 out of every 50 children
- Occasional cases of fussiness, drowsiness, or loss of appetite
About 1 out of every 2 adults who receive the PPSV vaccine have redness or pain where the shot is given. Less than 1% have a more severe reaction, such as a fever or muscle aches.
Who Should Get the Pneumococcal Vaccine and When Should It Be Given?
The PCV vaccine is recommended for the following children and adults:
Pneumococcal vaccine safe schedule
All infants younger than 24 months should receive four doses of the vaccine, using the following schedule:
- First shot at 2 months
- Second shot at 4 months
- Third shot at 6 months
- Booster at 12-15 months
Children who don't get their shot at these times should still get the vaccine. The number of doses and time between doses will depend on the child's age.
Healthy children aged 2-5 years who didn't complete the four doses or didn't receive any doses should receive one dose of the vaccine.
Children aged 6-18 who are at high risk of getting pneumococcal disease may need an extra dose of a PCV (PCV13, PCV15, or PCV20) even if they completed their shots as infants.
Healthy adults over 50 should get:
- One dose of PCV15 followed by a dose of PPSV23 at least a year later, or
- One dose of PCV20, or
- One dose of PCV21
Adults aged 18 to 49 who are at an increased risk for pneumococcal disease follow the same pneumococcal vaccine guidelines as for healthy adults over 50. Examples of increased risk include long-term use of steroids, chemotherapy, or radiation therapy.
In addition, anyone aged 2-49 with one of the following (or similar) health conditions that affect the immune system should be vaccinated with PPSV:
- Hodgkin's disease
- Lymphoma or leukemia
- Kidney failure
- Multiple myeloma
- Nephrotic syndrome
- HIV infection or AIDS
- Damaged spleen or no spleen
- Organ transplant
- Heart disease
- Lung disease
- Sickle cell disease
- Diabetes
- Alcoholism
- Cirrhosis
- Cerebrospinal fluid leak
- Cochlear implant
The PPSV shot may be given eight weeks after the PCV15 shot in certain situations. Those who are at high risk and those who were vaccinated before age 50 may need to be revaccinated five years after the first dose.
Pneumococcal Vaccine Side Effects
Side effects of the pneumococcal vaccine are minimal. For the pneumococcal conjugate vaccines (PCV15, PCV20, PCV21), possible side effects include:
- Redness, swelling, pain, or tenderness in the area where you got the shot
- Chills or fever
- Loss of appetite
- Tiredness
- Headache or joint pain
- Irritability in young kids
For PPSV23, the possible side effects are:
- Redness, swelling, pain, or tenderness in the area where you got the shot
- Fever
- Tiredness
- Muscle aches
If you do notice side effects, they're usually mild and gone within two days.
How Important Is It for an Adult Over Age 50 to Get Vaccinated?
In 2024, the CDC recommended lowering the age for pneumococcal vaccine from 65 to 50. And for a good reason.
"While invasive pneumococcal infection rates and mortality are highest in those aged 65 years and older (as the basis for the previous adult recommendation), adults aged 50-64 years have the second highest rate of disease," says Monica M. Farley, MD, President-Elect, National Foundation for Infectious Diseases and professor emerita of infectious diseases at Emory University School of Medicine. "In fact, disease rates peak among Black adults between age 55-59 years."
So, getting vaccinated after you turn 50 is very important. "Getting vaccinated against pneumococcal disease can help protect adults age 50 years and older against serious disease, especially those who have medical conditions such as heart disease, lung disease (asthma or COPD), and liver disease or those who are immunocompromised," she says.
If you're over the age of 50 or have an underlying medical condition that puts you at risk and haven't had a pneumococcal vaccine, talk to your doctor and ask to schedule one. According to the National Foundation for Infectious Disease, the death rates from bacteremia and meningitis caused by invasive pneumococcal disease are very high in older people and people who have underlying medical conditions. Bacteremia kills about 1 in 8 adults, and pneumococcal meningitis kills about 1 in 6 older adults who are infected.
Takeaways
Pneumococcal disease can cause breathing problems and serious infections such as pneumonia and meningitis. Luckily, there are several vaccines available. These are targeted mainly at children under 5 and adults over 50, as these are the age groups most likely to get pneumococcal diseases. However, people of other ages who have certain medical conditions may also wish to get the vaccine or a booster.
Pneumococcal Vaccine FAQs
Is the pneumococcal vaccine really necessary?
Yes, if you're in a higher-risk group, such as under 5, over 50, or have a medical condition that may affect your immune system. These medical conditions include Hodgkin's disease, lymphoma, and kidney disease. Children and teens who never received their pneumococcal shots as infants should still get the shot
What is the cost of a pneumococcal vaccine?
The price varies widely depending on whether you have insurance and where you get your vaccine from. Most your insurance plans fully cover vaccinations and you don't have to pay anything extra. If you don't have insurance, you could pay around $160-$200. Price may vary depending on the type of pneumococcal vaccine you get.
