Pneumococcal Vaccine Recommendations

Key points

  • CDC recommends pneumococcal vaccination for children younger than 5 years and adults 50 years or older.
  • CDC also recommends pneumococcal vaccination for children and adults at increased risk for pneumococcal disease.
  • Follow the recommended immunization schedule to ensure that your patients get the pneumococcal vaccines that they need.
Doctor putting a blue bandaid on older adult woman's arm.

Background

App available to interpret recommendations‎

CDC offers PneumoRecs VaxAdvisor as a free app to quickly and easily provide patient-specific pneumococcal vaccine guidance. It's available for download for iOS and Android mobile devices. There's also a web-based version that doesn't require a download.
PneumoRecs VaxAdvisor

The United States uses 2 types of pneumococcal vaccines. Each individual vaccine helps protect against different serotypes of pneumococcal bacteria.

  • Pneumococcal conjugate vaccines (PCVs)
    • PCV15
    • PCV20
    • PCV21
  • Pneumococcal polysaccharide vaccine
    • PPSV23

The following summarizes CDC's current age- and risk-based pneumococcal vaccine recommendations. Access the official, full text of CDC's current and historical pneumococcal vaccine recommendations.

Infants and children

Routine vaccination

CDC recommends routine pneumococcal vaccination for all children younger than 5 years old.

Administer a 4-dose PCV series (PCV15 or PCV20), 1 dose at each of the following ages:

  • 2 months
  • 4 months
  • 6 months
  • 12 through 15 months

Catch-up guidance

Vaccinate children younger than 5 years of age who miss their shots or start the series later than recommended. The number of doses recommended and the intervals between doses will depend on the child's age when vaccination begins.

Job aid for simplifying PCV catch-up ‎

Get assistance interpreting table 2 of the child and adolescent immunization schedule. This guidance applies to healthy children 4 months through 4 years of age.
View or download the job aid

Adults 50 years or older

Routine vaccination

Administer PCV15, PCV20, or PCV21 for all adults 50 years or older

  • Who have never received any pneumococcal conjugate vaccine
  • Whose previous vaccination history is unknown

PCV15: Additional vaccination needed

If PCV15 is used, administer a dose of PPSV23 Aone year later, if neededB. Their pneumococcal vaccinations are complete.

The minimum interval is 8 weeks and can be considered in adults with:

PCV20 or PCV21: Additional vaccination not recommended

If PCV20 or PCV21 is used, a dose of PPSV23 isn't indicated. Regardless of which vaccine is used (PCV20 or PCV21), their pneumococcal vaccinations are complete.

Recommendation for shared clinical decision-making

Based on shared clinical decision-making, 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 have received both

  • PCV13 (but not PCV15, PCV20, or PCV21) at any age and
  • PPSV23 at or after the age of 65 years old

Job aids for adult pneumococcal vaccination‎

Shared clinical decision-making: This job aid should assist vaccine providers in discussions with older adults considering PCV20 or PCV21 vaccination.



Vaccine timing for adults: This job aid should help vaccine providers interpret adult pneumococcal vaccine recommendations.

Risk-based recommendations

In certain situations, children 2 through 18 years of age may need additional pneumococcal vaccine doses. In addition, adults younger than age 50 years of age may be recommended to receive pneumococcal vaccines.

Risk-based indications for pneumococcal vaccination vary by patient age. The type of vaccine and number of doses can also vary by age and vaccination history.

Keep Reading: Summary of Risk-based Pneumococcal Vaccination Recommendations

Resources

Contraindications and precautions

General Best Practice Guidelines for Immunization

Pink Book chapter on pneumococcal disease

Immunization schedules

Child and adolescent immunization schedule

Adult immunization schedule

Pneumococcal Vaccine Information Statements

PCV: English | Other languages

PPSV23: English | Other languages

Print
Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases
  1. If PPSV23 is not available, one dose of PCV20 or PCV21 may be given.
  2. Only one dose of PPSV23 is indicated. If previously administered, another dose isn't needed.