About Pneumococcal Infection and Disease
Pneumococcal disease is a term used for a wide range of infections caused by bacteria called Streptococcus
pneumoniae (pneumococcus).
Ear and sinus infections are examples of mild infections these bacteria can cause. The following types of pneumococcal disease can be very serious, even deadly:
- Pneumonia (lung infection)
- Bacteremia (bloodstream infection)
- Meningitis (infection of the lining of the brain and spinal cord)
Invasive pneumococcal disease (IPD) means the bacteria invade parts of the body, such as blood, that are normally free from germs. These infections typically have more severe outcomes and can be difficult to treat and manage.
Pneumococcal disease is common in young children, but older adults are at greatest risk of serious illness and death. Vaccines are an effective, recommended intervention strategy to prevent the risk of infection and complications of pneumococcal disease.
Pneumococcal Vaccination
- CDC recommends pneumococcal vaccination for children younger than 5 years and all adults 50 years or older.
- CDC also recommends pneumococcal vaccination for children 5-18 years and adults 19-49 years of age at increased risk for pneumococcal disease. [see risk factors below]
2025 Available FDA Approved Pneumococcal Vaccines
| Vaccine Name | Vaccine Type | Dose/Administration |
|---|---|---|
| Capvaxive (PCV21) | Pneumococcal 21-valent conjugate vaccine | 0.5 mL, intramuscular injection |
| Prevnar 20 (PCV20) | Pneumococcal 20-valent conjugate vaccine | 0.5 mL, intramuscular injection |
| Vaxneuvance (PCV15) | Pneumococcal 15-valent conjugate vaccine | 0.5 mL, intramuscular injection |
| Pneumovax 23 (PPSV23) | Pneumococcal polysaccharide vaccine | 0.5 mL, intramuscular or subcutaneous injection |
Adult Vaccination Schedule per CDC
CDC recommends PCV15, PCV20, or PCV21 for adults who never received a PCV and are
- Ages 50 years or older
- Ages 19 through 49 years with certain risk conditions
If PCV15 is used, it should be followed by a dose of PPSV23 one year later, if needed.
Adults who received an earlier PCV (PCV7 or PCV13) should discuss with a vaccine provider. Most of these individuals will be recommended to be given one dose of PCV20 or PCV21 at least 1 year after the previous PCV7 or PCV13 dose.
For older adults who may have already received PCV13 or PPSV23
Adults 65 years or older have the option to get PCV20 or PCV21, or to not get additional pneumococcal vaccines. They can get PCV20 or PCV21 if they’ve already received one or both of the following:
- PCV13 (but not PCV15 or PCV20) at any age
- PPSV23 at or after the age of 65 years
These adults can talk with a vaccine provider and decide based on their risk factors, whether or not to get vaccinated (i.e., receive PCV20 or PCV21).
Adverse Reactions
Serious adverse reactions to pneumococcal vaccines are uncommon. Mild type reactions to vaccine administration described below may occur and typically resolve on their own within 1-2 days.
PCV15, PCV20, or PCV21
- Redness, swelling, pain, or tenderness at vaccination site
- Fever or chills
- Loss of appetite
- Feeling tired
- Headache
- Muscle aches or joint pain
PPSV23
- Redness or pain at vaccination site
- Feeling tired
- Fever
- Muscle aches
Allergies, reactions: review with your vaccine provider
Talk with a vaccine provider about your vaccination history and a specific vaccine’s ingredients. The below scenarios are considered contraindications to pneumococcal vaccines.
Someone should not get PCV15, PCV20, or PCV21 if they:
- Had a life-threatening allergic reaction after any type of PCV
- Had a life-threatening allergic reaction to any vaccine containing diphtheria toxoid
- DTaP is an example
- Have a severe allergy to any part of these vaccines
Someone should not get PPSV23 if they:
- Are younger than 2 years old
- Had a life-threatening allergic reaction after getting PPSV23
- Have a severe allergy to any part of PPSV23
Heightened Risk Factors for Pneumococcal Disease
Certain age groups, race and ethnicity groups, children in group care settings, and the following medical conditions have been identified by the CDC as risk factors for developing severe Pneumococcal disease, and may benefit from vaccination:
| Alcoholism | HIV infection |
| Cerebrospinal fluid (CSF) leak | Hodgkin disease |
| Chronic heart, liver, or lung disease (i.e. COPD, asthma, emphysema) | Iatrogenic immunosuppression |
| Chronic renal failure | Leukemia |
| Cigarette smoking | Lymphoma |
| Cochlear implant | Multiple myeloma |
| Congenital or acquired asplenia | Nephrotic syndrome |
| Congenital or acquired immunodeficiencies | Sickle cell disease or other hemoglobinopathies |
| Diabetes mellitus | Solid organ transplant |
| Generalized malignancy |
For more information regarding pneumococcal infection and how risk factors for developing severe pneumococcal disease, please visit: https://www.cdc.gov/pneumococcal/causes/index.html#cdc_causes_risk-risk-factors
Additional Notes for Pneumococcal Vaccination
- The guidelines and vaccine products for pneumococcal vaccines have been changing over the years and it is very common for eligible persons to not have completed the current recommended schedule. If a person has had pneumococcal vaccines in the past, it is important to assess their history and determine if they need additional vaccines to complete their pneumococcal vaccinations.
- These determinations can be made by utilizing the CDC PneumoRecs VaxAdvisor app / website. This tool can be used to determine the need for additional vaccinations based on information regarding age, vaccine history and pertinent medical conditions. To access this tool, please visit: https://www2a.cdc.gov/vaccines/m/pneumo/pneumo.html or
- Download “PneumoRecs VaxAdvisor” free for iOS and Android devices.
- CDC Recommendation Webpage: https://www.cdc.gov/pneumococcal/hcp/vaccine-recommendations/
