Pneumococcal Vaccine: Types, Schedule, and Side Effects

Pneumococcal vaccines are the most effective way to protect yourself or your child against pneumococcal disease, including ear infections, pneumonia (lung infection), blood infection, and meningitis (infection of the brain lining).

These vaccines are not the same as a flu vaccine. Pneumococcal vaccines protect against a type of bacteria, not a virus such as the flu.

Many babies or young children now get the recommended pneumococcal vaccine series. It is also recommended for all adults age 65 and older who are not known to have previously received a pneumococcal vaccine. People under age 65 may need vaccination if there is no record of the vaccination or if they have a medical condition that increases their risk of pneumococcal disease.

This article will discuss pneumococcal disease, the available vaccines, side effects, and more.

A baby with an adhesive bandage on a vaccination site on the thigh

Karl Tapales / Getty Images

Pneumococcal Disease

Pneumococcal disease is caused by a bacterium called Streptococcus pneumoniae. This bacterium can infect various parts of the body, causing different kinds of illness.

For instance, it can cause pneumonia in the lungs, bacteremia in the blood, and meningitis if it invades the covering of the brain. All of these are serious (and can be fatal), especially in children under age 2 and adults 65 and over. The bacterium can also cause ear infections or sinus infections (sinusitis).

The bacterium is transmitted from person to person. You can acquire it from being in close contact with someone else, like from someone sneezing or coughing. Some people may not know they have the bacterium in their nose or throat and inadvertently transmit it to others.

Symptoms of the illness depend on the area affected, although many people have multiple types of pneumococcal infection at the same time. Symptoms can include:

  • Shortness of breath
  • Chest pain
  • High fever
  • Chills
  • Cough

The best way to reduce your risk of pneumococcal disease is vaccination.

Types of Pneumococcal Vaccines

There are four pneumococcal vaccines available. Different vaccines are recommended depending on age and medical status.

Three pneumococcal conjugate vaccines (PCV13, PCV15, and PCV20) and one pneumococcal polysaccharide vaccine (PPSV23) are licensed by the Food and Drug Administration (FDA) for protection against pneumococcal disease.

What Is a Serotype?

A serotype is a variation of a bacterium or virus. The immune system may react differently to various serotypes. The effects in the body may also vary by serotype, producing different kinds or severity of illness.

PCV13, PCV15, and PCV20

Pneumococcal conjugate vaccines have complex sugar molecules (polysaccharides) unique to different serotypes attached to a protein. The addition of the protein enhances the immune system's response and memory.

Either PCV13 or PCV15 is given as a routine infant vaccination series. PCV13, also known as Prevnar 13, was approved by the FDA in 2010 for children and 2011 for adults. It replaced PCV7. It protects against 13 serotypes of pneumococcal bacteria that cause the most severe infections in kids and adults.

PCV15, also known as Vaxneuvance, was first licensed for adults in 2021 and was expanded to include all people from age 6 weeks and up in 2022. It protects against 15 serotypes.

PCV20, also known as Prevnar 20, was licensed in 2021 for adults 18 years and older (although recommendations to give it are for adults 19 and older). It covers 20 serotypes.

It's recommended that adults 65 and older receive either PCV15 or PCV20. Adults 19 to 65 with medical conditions that increase their risk of pneumococcal disease may receive PCV20. Children or teens at higher risk may receive PCV15.


PPSV23, known as Pneumovax 23, was approved by the FDA in 1983. It protects against 23 serotypes of pneumococcal bacteria. It has polysaccharides unique to the serotypes, but they are not attached to a protein.

Two groups may receive PPSV23. If an adult 19 or older receives PCV15, they should also get PPSV23. It may also be given to children 2 through 18 with medical conditions that increase their risk of pneumococcal disease.

Vaccine Effectiveness

Pneumococcal vaccination in children significantly reduces invasive disease (one study showed it reduced invasive disease by 97%), as well as ear infections and pneumonia.

Routine infant vaccination also reduces transmission of the serotypes (variations) of the type of bacteria covered by the vaccines. This can help reduce transmission to those who are unvaccinated. The PCV vaccines reduce carrying bacteria in the respiratory tract (but PPSV23 does not).

In a major randomized placebo-controlled trial (CAPiTA) of adults 65 and over, PCV13 vaccines showed 75% efficacy against invasive pneumococcal disease by serotypes covered by the vaccine.

The PPSV23 vaccine has been shown to have efficacy rates of 60% to 70% in helping to prevent invasive disease caused by serotypes covered by the vaccine.

PCV15 and PCV20 are still too new to have good data on how effective they are in widespread use.

Pneumococcal vaccines should offer ongoing protection, perhaps for life. The need for an additional pneumococcal vaccine depends on the type of vaccine a person has received and their underlying medical conditions.

If you are concerned about your disease risk, talk with a healthcare provider about your medical situation, vaccination status, and ways to help keep you healthy and safe.

Vaccines Reducing Pneumococcal Disease

Since the introduction of pneumococcal vaccines, the rates of invasive pneumococcal disease by the serotypes covered have decreased dramatically.

Pneumococcal Vaccine Side Effects

Like any other medication or vaccine, there may be side effects from the pneumococcal vaccine. If you do get side effects, they are typically very mild and only last a day or two.

Common side effects include:

  • Drowsiness
  • Appetite loss
  • Sore or swollen arm from the shot
  • Fever
  • Headache

Anaphylactic reactions (a severe whole-body allergic reaction) to the shot are possible, but very rare.

If you have had a severe allergic reaction to a previous pneumococcal vaccine or any vaccine containing diphtheria toxoid, do not get a PCV shot. If you have allergies to certain vaccine ingredients, talk with your healthcare provider about the ingredients of these vaccines to make sure you are not allergic to a component. 

Who Should Get the Pneumococcal Vaccine and When?

Vaccination is recommended for those at increased risk, including:

  • Children 2 years old and younger
  • Adults 65 or older who have not received a pneumococcal vaccine (they should receive PCV15 or PCV20 if previously only received PPSV23)
  • Children and adults aged 2 through 64 with certain conditions, including lung disease, kidney disease, liver disease, diabetes, and human immunodeficiency virus (HIV), or who are immunocompromised for various reasons

Children typically get doses of PCV vaccines at 2, 4, and 6 months, and then once again between 12 and 15 months.

For adults, the timing and type of vaccine depend on whether you have had a previous vaccination or if you have a medical condition that puts you at risk for infection. Talk with a healthcare provider about whether you need additional protection against pneumococcal disease.

You may receive a pneumococcal vaccine at the same time as a flu vaccine.


A certain kind of bacteria causes pneumococcal disease, which includes noninvasive and invasive health conditions (such as ear infections and pneumonia), some of which can be fatal. The bacterium is easily transmitted from person to person through droplets in the air, including by people who have no symptoms.

Vaccination is the best way to help prevent pneumococcal illness. It is recommended for infants, people age 65 and older, and children and adults at greater risk of serious pneumococcal disease.

The vaccine is generally well-tolerated. While people vaccinated for pneumococcal disease have ongoing protection, they may need an additional type of pneumococcal vaccine depending on their initial vaccine type and whether they have certain medical conditions that put them at higher risk.

Talk with a healthcare provider about your risk for pneumococcal disease, your medical and vaccination history, and what you can do to keep yourself safe and healthy.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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