Overview

Young children are commonly affected by pneumococcal disease, however, older adults are at the highest risk of severe sickness and fatality. Within the United States, there are two types of vaccines administered to prevent pneumococcal disease:

• Pneumococcal conjugate vaccines (PCV13, PCV15, and PCV20)
• Pneumococcal polysaccharide vaccine (PPSV23)

The Centers for Disease Control and Prevention (CDC) suggests that all children under the age of 5, as well as adults over the age of 65, receive pneumococcal immunization. In specific circumstances, certain other children and adults may also require pneumococcal vaccinations. The following provides further details regarding who should and should not obtain each variety of pneumococcal vaccine.

PCVs

For the prevention of pneumococcal disease, the CDC suggests administering PCV13 or PCV15 to children below the age of 5 and children aged 5 to 18 with specific medical conditions that raise their susceptibility to pneumococcal disease.

If an individual has not been given any pneumococcal conjugate vaccine previously, the CDC mandates vaccination with either PCV15 or PCV20 for individuals 65 years of age or older and individuals aged 19 to 64 with particular medical conditions or other potential risk factors.

Individuals who have received a previous pneumococcal conjugate vaccine (either PCV13 or PCV7) should discuss with their vaccine provider to explore various options to conclude their pneumococcal vaccination series.

For individuals aged 65 and above who have already been immunized with PCV13 (but not PCV15 or PCV20) at any stage and also had PPSV23 vaccination at 65 years or above, they can choose to discuss with their health care provider the possibility of getting PCV20. Consequently, the decision to get PCV20 should be made after consulting with their physician.

PPSV23

For children aged 2-18 years old who have specific medical conditions that put them at risk of pneumococcal disease, and adults aged 19 or above who receive PCV15, the CDC advises PPSV23 vaccination.

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)

Vaccine Recommendations for Infants and Children

The CDC advises that all children under the age of 2 receive routine pneumococcal conjugate vaccine (either PCV13 or PCV15), according to the following recommended dosage schedule: administer the vaccine series in 4 doses to infants, with one dose given at each of the following age intervals: 2 months, 4 months, 6 months, and 12-15 months. If a child misses a dose or starts the series later, vaccination is still recommended, and the number of doses and duration between them will be determined by the child’s age at the onset of vaccination.

Vaccine Recommendations for Adults 65 Years or Older

The CDC recommends administering routine pneumococcal conjugate vaccine (either PCV15 or PCV20) for all adults aged 65 or older who have not previously received any such vaccine or whose vaccination history is unknown. If PCV15 is given, a dose of PPSV23 should be administered one year later, with the minimum interval being 8 weeks, which may be considered for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. However, if PCV20 is used, PPSV23 dose is not necessary. For further information on vaccination options for adults who have had previous pneumococcal conjugate vaccine doses, refer to the CDC’s Pneumococcal Vaccination: Summary of Who and When to Vaccinate guide.