Pneumococcal Vaccines

What Do I Need to Know About the Pneumococcal Pneumonia Vaccine?

Author/s: 
Jerard Z. Kneifati-Hayek, Michael A. Incze

What Is the Pneumococcal Pneumonia Vaccine?
The pneumococcal vaccine protects against infections from a type of bacteria called pneumococcus. Pneumococcus is a common cause of pneumonia (a lung infection), as well as other serious infections. The vaccine prepares your immune system to recognize and fight pneumococcal bacteria. The vaccine is usually given through an injection into the arm. Some versions can also be inhaled. The vaccines do not contain living or dead bacteria. The pneumococcal vaccine does not protect you from other lung infections like the flu (influenza), COVID-19, RSV (respiratory syncytial virus), or other kinds of bacteria that cause pneumonia. It is still important to get your flu shot every year and other vaccines your doctor recommends, even if you already got the pneumococcal vaccine.

What Are Benefits of Pneumococcal Pneumonia Vaccines?
The vaccine substantially lowers your risk of hospitalization or dying from serious pneumococcal infection. Vaccination can reduce the risk of pneumonia-related deaths by almost half.

Why Is There a New Pneumococcal Pneumonia Vaccine, and How Does It Differ From Prior Versions?
There are several types of pneumococcal bacteria that can cause pneumonia. Being vaccinated against one type of pneumococcus may not protect you from other types that could make you sick. Previous pneumococcal pneumonia vaccines like PPSV23 or PCV13 do not protect against all types of the pneumococcal bacteria that cause pneumonia. Newer vaccines were made in 2021 (PCV15 and PCV20) and 2024 (PCV21). These help to prevent infections from types of bacteria not covered by older versions.

What Are the Potential Side Effects?
Side effects are frequent but generally mild. The most common side effect is pain or redness at the site of injection. Less common side effects include fever, feeling tired, muscle ache, and headache. These are less severe than for other vaccines like flu and shingles. These effects can be treated with over-the-counter medications and generally go away within 24 to 48 hours. Life-threatening allergic reactions are extremely rare but possible. Seek immediate medical attention if you experience severe symptoms like difficulty breathing or progressive weakness after vaccination. The pneumonia vaccine cannot cause pneumonia or other bacterial illness.

Who Should Get a New Pneumococcal Pneumonia Vaccine?
All adults 50 years and older who have not been vaccinated should receive one of the new vaccines: PCV21, PCV20, or a sequence of PCV15 followed by PPSV23. People younger than 50 years with certain health problems should also get the new vaccine. These health problems include diabetes; chronic conditions affecting the heart, lungs, liver, or kidneys; current tobacco use or heavy alcohol consumption; a weak immune system from certain health problems or medications; absence or prior removal of the spleen; and a history of spinal fluid leak or a cochlear (inner ear) implant.

Most adults who got either PPSV23 and/or PCV13 should still get a booster with one of the newer vaccines. The different pneumococcal vaccines protect against different types of bacteria. Some types of bacteria are more common in people depending on their age, health, and where they live. Talk to your doctor about which vaccine is best for you.

Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Updated Recommendations of the Advisory Committee on Immunization Practices

Author/s: 
Matanock, A, Lee, G, Gierke, R, Kobayashi, M, Leidner, A, Pilishvili, T

Two pneumococcal vaccines are currently licensed for use in adults in the United States: a 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Pfizer, Inc.]) and a 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23, Merck and Co., Inc.]). In 2014, the Advisory Committee on Immunization Practices (ACIP)* recommended routine use of PCV13 in series with PPSV23 for all adults aged ≥65 years based on demonstrated PCV13 safety and efficacy against PCV13-type pneumonia among adults aged ≥65 years (1). At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). On June 26, 2019, after having reviewed the evidence accrued during the preceding 3 years (https://www.cdc.gov/vaccines/acip/recs/grade/PCV13.html), ACIP voted to remove the recommendation for routine PCV13 use among adults aged ≥65 years and to recommend administration of PCV13 based on shared clinical decision-making for adults aged ≥65 years who do not have an immunocompromising condition,† cerebrospinal fluid (CSF) leak, or cochlear implant, and who have not previously received PCV13. ACIP recognized that some adults aged ≥65 years are potentially at increased risk for exposure to PCV13 serotypes, such as persons residing in nursing homes or other long-term care facilities and persons residing in settings with low pediatric PCV13 uptake or traveling to settings with no pediatric PCV13 program, and might attain higher than average benefit from PCV13 vaccination. When patients and vaccine providers§ engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for a particular person, considerations might include both the person's risk for exposure to PCV13 serotypes and their risk for developing pneumococcal disease as a result of underlying medical conditions. All adults aged ≥65 years should continue to receive 1 dose of PPSV23. If the decision is made to administer PCV13, it should be given at least 1 year before PPSV23. ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ≥19 years with an immunocompromising condition, CSF leak, or cochlear implant (2).

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