Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. Review of pneumococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present, as persons with sickle cell disease are at risk of serious pneumococcal infections. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.
Who Should Get Immunised Against Pneumococcal Disease
Anyone who wants to protect themselves against pneumococcal disease can talk to their doctor about getting immunised.
Pneumococcal immunisation is recommended for:
- infants and children aged under 5 years
- non-Indigenous adults aged 70 years and over without medical risk conditions for pneumococcal disease
- Aboriginal and Torres Strait Islander children aged under 5 years living in Northern Territory, Queensland, South Australia and Western Australia
- Aboriginal and Torres Strait Islander adults aged 50 years and over without medical risk conditions for pneumococcal disease
- infants under 12 months diagnosed with certain medical risk conditions for pneumococcal disease
- people over 12 months with certain medical risk conditions for pneumococcal disease
There are two types of pneumococcal vaccine provided free under the National Immunisation Program for different age groups and circumstances:
Refer to the NIP schedule for vaccine dosage information. Your doctor or vaccination provider will advise if you or your child have a specified medical risk condition.
Refer to the pneumococcal recommendations in the Australian Immunisation Handbook for more information.
Know The Facts About The Pneumonia Vaccine
Just as with a flu shot, and now the COVID-19 vaccines, some people believe that getting a pneumococcal vaccine will cause them to come down with the disease or experience long-term side effects.
This is absolutely not true, Dr. Suri says.
Not only will the pneumococcal vaccine help reduce the risk of contracting certain types of bacterial pneumonia, it also guards against serious consequences resulting from the flu and severe infections, such as .
For young children, older adults, smokers and those with other risk factors, the vaccine is a healthy choice to make.
I cant see any reason to avoid this vaccine and every reason to get it, she says.
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Why Is Pneumococcal Vaccine Important
Pneumococcal vaccine can prevent pneumonia and other infections caused by 23 types of the Streptococcus pneumoniae bacteria. These 23 types account for approximately nine out of 10 cases of pneumococcal disease. The vaccine is recommended for people with certain medical conditions listed below, and people 65 years of age and older. About eight out of 10 cases occur in these high- risk groups. The vaccine protects about 50 to 80 per cent of people against pneumococcal infection. Vaccination also makes the disease milder for those who may catch it. This pneumococcal vaccine has been used in Canada since 1983.
Common And Local Adverse Events

Pneumococcal conjugate vaccine
Studies of Pneu-C-13 vaccine indicated that irritability decreased appetite increased or decreased sleep and pain, swelling and redness at the injection site after the toddler dose and in older children, are common side effects. Low grade fever occurred in 20% to 30% or more of vaccine recipients. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38°C occurring in approximately 3% of vaccine recipients.
Pneumococcal polysaccharide vaccine
Reactions to Pneu-P-23 vaccine are usually mild. Soreness, redness and swelling at the injection site occur in 30% to 60% of vaccine recipients and more commonly follow SC administration than IM administration. Occasionally, low grade fever may occur. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. However, severe injection site reactions, including reports of injection site cellulitis and peripheral edema in the injected extremity, have been documented rarely with Pneu-P-23 vaccine in post-marketing surveillance, even with the first dose. Multiple re-vaccinations are not recommended refer to Booster doses and re-immunization.
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Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and should be started on an immunization schedule appropriate for their age and risk factors. Pneumococcal vaccines may be given, regardless of possible previous receipt of the vaccines, as adverse events associated with repeated immunization have not been demonstrated. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
Concurrent Administration Of Vaccines
Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
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Causes And Types Of Pneumonia
Viruses, bacteria, and fungi can all cause pneumonia. In the United States, common causes of viral pneumonia are influenza virus, respiratory syncytial virus , and SARS-CoV-2 . A common cause of bacterial pneumonia is Streptococcus pneumoniae . These bacteria can cause a wide range of infectionslike pneumoniaknown as pneumococcal disease.
There are several ways people can get sick with pneumonia:
- Community-acquired pneumonia ,
- Healthcare-associated pneumonia, and
Learn more about the causes of pneumonia.
Vaccines For Children Program
The Vaccines for Children Program provides vaccines to children whose parents or guardians may not be able to afford them. A child is eligible if they are younger than 19 years old and meets one of the following requirements:
- Medicaid-eligible
- American Indian or Alaska Native
- Underinsured
If your child is VFC-eligible, ask if your doctor is a VFC provider. For help in finding a VFC provider near you, contact your state or local health departments VFC Program Coordinator or call CDC at 1-800-CDC-INFO .
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How Is Prevnar 13 Given
Prevnar 13 is given as an injection into a muscle.
For infants and toddlers, the pneumococcal 13-valent vaccine is given in a series of shots. The first shot is usually given when the child is 6 weeks to 2 months old. The booster shots are then given at 4 months, 6 months, and 12 to 15 months of age.
If your child is 7 months to 5 years old, he or she can still receive Prevnar 13 on the following schedule:
-
Age 7-11 months: Two shots at least 4 weeks apart, followed by a third shot after the child turns 1 year .
-
Age 12-23 months: Two shots at least 2 months apart.
-
Age 24 months to 5 years : One shot.
The timing of this vaccination is very important for it to be effective. Your child’s individual booster schedule may be different from these guidelines. Follow your doctor’s instructions or the schedule recommended by your local health department.
For adults and children older than 5 years, Prevnar 13 is usually given as one shot.
Be sure to keep your child on a regular schedule for other immunizations such as diphtheria, tetanus, pertussis , hepatitis, and varicella . Your doctor or state health department can provide you with a recommended immunization schedule.
Path To Improved Health
Pneumococcal vaccines can protect you against getting pneumonia, which is contagious and spreads from close, person-to-person contact. Pneumonia is an infection of the lungs and can lead to many symptoms, including:
- cough
- chest pains
- bringing up mucus when you cough
For seniors, pneumonia can be very serious and life-threatening. This is especially true if you have a chronic condition, such as diabetes or COPD. Pneumonia can also develop after youve had a case of the flu or a respiratory virus such as COVID-19. It is extremely important to stay current on flu shots each year in addition to your pneumococcal vaccines.
While PPSV23 and PCV13 do not protect against all types of pneumonia, they can make it less likely that you will experience severe and possibly life-threatening complications from the illness.
The American Academy of Family Physicians recommends that seniors who have not had either pneumococcal vaccine should get a dose of PCV13 first, and then a dose of PPSV23 6-12 months later. The vaccines cannot be given at the same time. If you have recently had a dose of PPSV23, your doctor will wait at least one year to give you PCV13.
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The Different Types Of Pneumococcal Vaccine
The type of pneumococcal vaccine you’re given depends on your age and health. There are 2 types.
Pneumococcal conjugate vaccine is used to vaccinate children under 2 years old as part of the NHS vaccination schedule. It’s known by the brand name Prevenar 13.
Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards. The PPV vaccine is not very effective in children under the age of 2.
How The Pneumococcal Vaccine Works

Both types of pneumococcal vaccine encourage your body to produce antibodies against pneumococcal bacteria.
Antibodies are proteins produced by the body to neutralise or destroy disease-carrying organisms and toxins.
They protect you from becoming ill if you’re infected with the bacteria.
More than 90 different strains of the pneumococcal bacterium have been identified, although most of these strains do not cause serious infections.
The childhood vaccine protects against 13 strains of the pneumococcal bacterium, while the adult vaccine protects against 23 strains.
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What Are The Risks Of A Vaccine Reaction
- Redness, swelling, pain, or tenderness where the shot is given, and fever, loss of appetite, fussiness , feeling tired, headache, and chills can happen after PCV13 vaccination.
Young children may be at increased risk for seizures caused by fever after PCV13 if it is administered at the same time as inactivated influenza vaccine. Ask your health care provider for more information.
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
As with any medicine, there is a veryremote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.
Pneumococcal Vaccine Studies In The Future
Respiratory pathogens initiate colonization in the mucosal surface to cause disease. Therefore, the mucosal immune system plays an important role as a primary physical barrier in protection against respiratory diseases . In the mucosal immune system, secretory IgA, a key factor in mucosal immunity, is induced by vaccination to entrap microbes or block microbial adherence and invasion . Local IgG is also induced . Thus, mucosal vaccination induces both mucosal and systemic immune responses to provide effective protection against respiratory diseases such as pneumonia. Compared with mucosal vaccines, injectable vaccines are less effective at generating mucosal immune responses , and could transmit infection via the blood through contaminated needles . Despite the mucosal vaccines advantages, and their use against diseases such as cholera, polio and influenza, few of these vaccines are available . This is because the mucosal immune system reacts to mucosal vaccines as they do for microorganisms, making their implementation difficult i.e., the mucosal vaccine adheres to the mucosal surface and is subject to degradation by proteases and nucleases, triggering the same immune response as the real pathogen. Thus, to be feasible, mucosal vaccines must overcome this hurdle, and evoke secretory immune responses, such as secretory IgA.
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Are There Side Effects
Some people have side effects from the vaccine, but these are usually minor and last only a short time. It is quite common to have some swelling and soreness in the arm where the needle was given. Occasionally slight fever may occur. Other side effects – such as headache, a higher fever or fatigue may occur, but these are rare. You should always discuss the benefits and risks of any vaccine with your doctor.
Pneumonia And Long Covid
In a Q& A about lingering COVID-19 symptoms, the Cleveland Clinic notes that it is seemingly random who experiences long-lasting symptoms and who doesnt. So, its not quite clear whether having pneumonia in the past is connected with having long COVID.
As a way to find answers, in 2021, the National Institutes of Health launched an ongoing study into the underlying biological causes of prolonged symptoms and what makes some people more likely to get long COVID.
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The National Vaccine Injury Compensation Program
The National Vaccine Injury Compensation Program is a federal program that was created to compensate people who may have been injured by certain vaccines. Claims regarding alleged injury or death due to vaccination have a time limit for filing, which may be as short as two years. Visit the VICP website at or call to learn about the program and about filing a claim.
What Are The Side Effects
Vaccines are very safe. It is much safer to get the vaccine than to get pneumococcal disease.
Many people have no side effects from the vaccines. For those that do, side effects are usually mild and last 1 to 2 days . Serious side effects are very rare.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is a very rare possibility, between one in 100,000 and one in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes injection of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
It is important to always report serious or unexpected reactions to your immunizing health care provider.
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Types And Composition Of Pneumococcal Vaccines
The FDA licensed 1 conjugate and 1 polysaccharide vaccine for protection against pneumococcal disease.
Pneumococcal Conjugate Vaccine
Pneumococcal conjugate vaccine includes purified capsular polysaccharide of 13 serotypes of Streptococcus pneumoniae conjugated to a nontoxic variant of diphtheria toxin known as CRM197. A 0.5-milliliter PCV13 dose contains approximately 2.2 micrograms of polysaccharide from each of 12 serotypes and approximately 4.4 µg of polysaccharide from serotype 6B the total concentration of CRM197 is approximately 34 g. The vaccine contains 0.02% polysorbate 80, 0.125 milligrams of aluminum as aluminum phosphate adjuvant, and 5 mL of succinate buffer. The vaccine does not contain thimerosal preservative.
Pneumococcal Polysaccharide Vaccine
Pneumococcal polysaccharide vaccine includes purified preparations of pneumococcal capsular polysaccharide. PPSV23 contains polysaccharide antigen from 23 types of pneumococcal bacteria. It contains 25 µg of each antigen per dose and contains 0.25% phenol as a preservative.
- Conjugate: A type of vaccine that joins a protein to an antigen in order to improve the protection the vaccine provides
- Polysaccharide: A type of vaccine that is composed of long chains of sugar molecules that resemble the surface of certain types of bacteria in order to help the immune system mount a response
How Can I Learn More

- Ask your healthcare provider. He or she can give you the vaccine package insert or suggest other sources of information.
- Visit the website of the Food and Drug Administration for vaccine package inserts and additional information at .
- Contact the Centers for Disease Control and Prevention : call or visit CDC’s website at .
Pneumococcal Conjugate Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 8/6/2021.
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What If It Is Not Clear What A Person’s Vaccination History Is
When indicated, vaccines should be administered to patients with unknown vaccination status. All residents of nursing homes and other long-term care facilities should have their vaccination status assessed and documented.
How long must a person wait to receive other vaccinations?
Inactivated influenza vaccine and tetanusvaccines may be given at the same time as or at any time before or after a dose of pneumococcus vaccine. There are no requirements to wait between the doses of these or any other inactivated vaccines.
Vaccination of children recommended
In July 2000, the American Academy of Pediatrics and the CDC jointly recommended childhood pneumococcal immunization, since pneumococcal infections are the most common invasive bacterial infections in children in the United States.
“The pneumococcal conjugate vaccine, PCV13 or Prevnar 13, is currently recommended for all children younger than 5 years of age, all adults 65 years or older, and persons 6 through 64 years of age with certain medical conditions,” according to the 2014 AAP/CDC guidelines. “Pneumovax is a 23-valent pneumococcal polysaccharide vaccine that is currently recommended for use in all adults 65 years of age or older and for persons who are 2 years and older and at high risk for pneumococcal disease . PPSV23 is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma.”
How Does The Pneumonia Vaccine Work
There are currently two vaccines administered in the United States:
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