Administering Pneumococcal Vaccines

This page provides a brief summary of pneumococcal vaccine administration guidance, including route, number of doses, and co-administration with other vaccines.

Visual Inspection

Do not use any pneumococcal vaccine beyond the expiration date printed on the label.

Prior to administration, visually inspect the vaccine for particulate matter and/or discoloration. If these conditions exist, do NOT use.

Route, Site, and Needle Size

Administer pneumococcal polysaccharide vaccine (PPSV23) intramuscularly or subcutaneously.

Administer pneumococcal conjugate vaccines (PCV15, PCV20) intramuscularly.

• For infants and young children, use the vastus lateralis muscle in the anterolateral thigh.
• For older children and adults, use the deltoid muscle.

Administer pneumococcal conjugate vaccine (PCV21) to adults intramuscularly using the deltoid muscle.

Use a needle length appropriate for the age and size of the person receiving the vaccine.

Number and Timing of Doses

The primary series of PCV15 or PCV20 consists of 3 doses routinely given at 2, 4, and 6 months of age. You can administer the first dose as early as 6 weeks of age. CDC recommends a fourth (booster) dose at 12 through 15 months of age. For children vaccinated when they are younger than 12 months of age, the minimum interval between doses is 4 weeks. Separate doses given at 12 months of age and older by at least 8 weeks.

The number and timing of doses for older children and adults depends on the medical indication, prior pneumococcal vaccination, and age. See Pneumococcal Vaccine Recommendations for all pneumococcal vaccine recommendations by vaccine and age.

Predrawing Vaccine Doses

There are no data on the stability of vaccines stored in syringes filled by health care professionals. Therefore, CDC does not recommend predrawing vaccine doses. Do not open vaccine vials until time of administration.

Administration with Other Vaccines

Different Pneumococcal Vaccines

Never administer a pneumococcal conjugate vaccine (PCV15, PCV20, or PCV21) and PPSV23 during the same visit.

If someone is indicated to receive PCV15 and PPSV23, administer PCV15 first followed by PPSV23.

For children (2 through 18 years old), the interval between PCV15 and PPSV23 should be at least 8 weeks. If PPSV23 is inadvertently administered first, wait at least 8 weeks to administer PCV15.

For adults, the recommended interval is at least 1 year. An 8-week minimum interval can be considered for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. If PPSV23 is inadvertently administered first, wait at least 1 year to administer PCV15.

*  Summary of Risk-based Pneumococcal Vaccination Recommendations | Pneumococcal | CDC.
† The minimum interval is 8 weeks and can be considered in adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak.

Other Childhood Vaccines

You can administer PCV15, PCV20, or PPSV23 at the same time as most other routine childhood vaccinations.

Children may be at increased risk for febrile seizures if a pneumococcal conjugate vaccine is administered with inactivated influenza vaccine. However, clinicians may give either pneumococcal conjugate vaccine at the same time as an influenza vaccine.

Currently, no data from clinical trials are available for co-administration of PPSV23 with other childhood vaccines during the same visit.

Other Vaccines for Adults

In adults, you can administer a pneumococcal vaccine (PCV15, PCV20, PCV21, or PPSV23) during the same visit with influenza vaccination or other recommended vaccines. Administer each vaccine with a separate syringe and, if feasible, at a different injection site. Annual influenza vaccination is important to help prevent the flu. Additionally, since having the flu increases the risk of getting pneumococcal disease, receiving a flu vaccine is important for preventing pneumococcal disease.

In accordance with the General Best Practices for Immunization, routine administration of a pneumococcal vaccine with other age-appropriate doses of vaccines at the same visit is recommended for adults who have no specific contraindications to vaccination at the time of the health care visit.