What Pneumonia Vaccine Is Given First
The Advisory Committee on Immunization Practices recommends that pneumococcal vaccine-naïve people who will be receiving both PCV13 and PPSV23 should receive PCV13 first, followed by PPSV23 8 weeks later if they have a high-risk condition or one year later if they are 65 years and older without a high risk …
Who Should Get Pneumococcal Vaccines
CDC recommends pneumococcal vaccination for all children younger than 2 years old and all adults 65 years or older. In certain situations, older children and other adults should also get pneumococcal vaccines. Below is more information about who should and should not get each type of pneumococcal vaccine.
Talk to your or your childs doctor about what is best for your specific situation.
How Is The Pneumococcal Vaccine Made
Like the Hib vaccine, the pneumococcal vaccine is made from the sugar coating of the bacteria. Antibodies directed against the pneumococcal polysaccharide protect the child without having to take the risk that their first encounter with natural pneumococcus will result in permanent disabilities or death.
Unfortunately, children less than 2 years old don’t develop very good immune responses to this polysaccharide alone. So the pneumococcal vaccine was made in a manner similar to the Hib vaccine . The pneumococcal polysaccharide is linked to a harmless protein. This version of the vaccine is referred to as the pneumococcal conjugate vaccine. Once linked, young children are able to make an immune response to the polysaccharide. The big difference between the pneumococcal vaccine and the Hib vaccine is the number of different types of polysaccharides that need to be included in the vaccine. Whereas, there is really only one strain of Hib that causes disease in children, there are about 90 different strains of pneumococcus. Fortunately, most of the serious disease in young children is caused by the 13 strains of pneumococcus contained in the vaccine.
The pneumococcal vaccine was found to be highly effective in preventing severe pneumococcal infection in a large trial of children injected with the vaccine. About 40,000 children were included in the initial trial of the vaccine. Since its licensure, the pneumococcal vaccine has been given to millions of children safely.
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People With Health Problems And The Pneumococcal Vaccine
The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.
This is generally the same people who are eligible for annual flu vaccination.
You’re considered to be at a higher risk of a pneumococcal infection if you have:
- a suppressed immune system caused by a health condition, such as HIV
- a suppressed immune system caused by medicines, such as chemotherapy or steroid tablets
- a cochlear implant
- had a leak of cerebrospinal fluid this could be the result of an accident or surgery
Adults and children who are severely immunocompromised usually have a single dose of PCV followed by PPV.
Who Should Get The Pneumococcal Vaccine

- Adults aged 65 years or older may only need 1 dose. Another dose of either vaccine may be given, if they are at least 1 year apart. Your healthcare provider will tell you if you need more vaccine doses and when to get them.
- Adults aged 19 to 64 at high risk for pneumococcal disease will need 1 or more doses of the vaccine. If you are Native Alaskan or American Indian, ask your healthcare provider if you need the vaccine. Any of the following can increase your risk for pneumococcal disease:
- A chronic heart or lung disease, or diabetes
- Liver disease or alcoholism
- A cerebrospinal fluid leak or cochlear implant
- A damaged or removed spleen, or sickle cell disease
- A weak immune system, HIV, cancer, kidney failure, or an organ transplant
- Living in a nursing home or long-term care facility
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Adults 19 Through 64 Years Old
CDC recommends pneumococcal vaccination for adults 19 through 64 years old who have certain chronic medical conditions or other risk factors. The tables below provide detailed information.
For adults with any of the conditions or risk factors listed below:
For those who have not previously received any pneumococcal vaccine, CDC recommends you:
- Give 1 dose of PCV15 or PCV20.
- If PCV15 is used, this should be followed by a dose of PPSV23 at least one year later. The minimum interval is 8 weeks and can be considered in adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak.
- If PCV20 is used, a dose of PPSV23 is NOT indicated.
For those who have only received PPSV23, CDC recommends you:
- May give 1 dose of PCV15 or PCV20.
- The PCV15 or PCV20 dose should be administered at least one year after the most recent PPSV23 vaccination.
- Regardless of if PCV15 or PCV20 is given, an additional dose of PPSV23 is not recommended since they already received it.
For those who have received PCV13 with or without PPSV23, CDC recommends you:
- Give PPSV23 as previously recommended.* See Pneumococcal Vaccine Timing for Adults for specific guidance. The incremental public health benefits of providing PCV15 or PCV20 to adults who have received PCV13 only or both PCV13 and PPSV23 have not been evaluated.
Number And Timing Of Doses
Vaccinate all children younger than 2 years old with PCV13. The primary series 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 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 Vaccination: Summary of Who and When to Vaccinate for all pneumococcal vaccine recommendations by vaccine and age.
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Children 2 Through 5 Years Old With Certain Medical Conditions
CDC recommends pneumococcal vaccination for children 2 through 5 years old who have certain medical conditions. The tables below provide detailed information by medical condition. You can also see table 11 for additional details.
For a child with any of these conditions:
- Cerebrospinal fluid leak
CDC recommends you:
- Give 2 doses of PCV13 if they are unvaccinated or received an incomplete PCV13 series with < 3 doses. Give the second dose at least 8 weeks after the first.
- Give 1 dose of PCV13 if they received 3 doses of PCV13 but none were given after 12 months of age.
- Give 2 doses of PPSV23 after the PCV13 series is complete. Give the first dose at least 8 weeks after any prior PCV13 dose, then give the second dose of PPSV23 at least 5 years after the first PPSV23 dose.
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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Which Adults Should Get The Pneumococcal Vaccine
The following groups of adults should get both types of the pneumococcal vaccine :
- Adults 65 years and older because they are at high risk of pneumococcal infections
- Adults without a functioning spleen
- Adults who are immune compromised by disease, chemotherapy or steroids
- Individuals who are HIV positive
The following groups of adults should get the polysaccharide pneumococcal vaccine regardless of age:
- Adults who smoke or suffer from alcoholism
- Adults with heart or lung disease, liver disease, asthma, diabetes or cancer
Can Tdap And Pneumococcal Vaccines Be Given Together
Asked by: Dr. Araceli Prosacco DVM
Influenza vaccine and Td may be given at the same time or at any time before or after a dose of pneumococcal polysaccharide vaccine. The only time you have to wait is when two LIVE vaccines are not given at the same visit then you need to wait at least 4 weeks to give the second live vaccine.
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Do You Need Tdap To Hold A Baby
I do. All close contacts to the newborn should be vaccinated with the annual influenza vaccine at least 2 weeks before meeting the baby. They should also have had Tdap in the last 10 years. If they have not received that vaccine, they should get a Tdap booster at least 2 weeks before meeting the baby.
Evidence Supporting Addition To Routine Vaccination Schedules

After introduction of the pneumococcal conjugate vaccine in 2000, several studies described a decrease in invasive pneumococcal disease in the United States. One year after its introduction, a group of investigators found a 69% drop in the rate of invasive disease in those of less than two years of age. By 2004, all-cause pneumonia admission rates had declined by 39% and rates of hospitalizations for pneumococcal meningitis decreased by 66% in children younger than 2.
Rates of invasive pneumococcal disease among adults have also declined since the introduction of the vaccine.
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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.
Whats The Difference Between Pcv13 And Ppsv23
PCV13 | |
helps protect you against 13 different strains of pneumococcal bacteria | helps protect you against 23 different strains of pneumococcal bacteria |
usually given four separate times to children under two | generally given once to anyone over 64 |
generally given only once to adults older than 64 or adults older than 19 if they have an immune condition | given to anyone over 19 who regularly smokes nicotine products like cigarettes or cigars |
- Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
- Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
- Dont get the shots too close together. Youll need to wait about a year in between each shot.
- Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.
- a vaccine made with diphtheria toxoid
- another version of the shot called PCV7
- any previous injections of a pneumonia shot
- are allergic to any ingredients in the shot
- have had severe allergies to a PPSV23 shot in the past
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Who Should Get Pneumococcal Conjugate Vaccine
CDC recommends pneumococcal vaccination for all children younger than 2 years old and all adults 65 years or older. In certain situations, older children and other adults should also get pneumococcal vaccines. Below is more information about who should and should not get each type of pneumococcal vaccine.
Extended Pneumococcal Immunisation For High
As part of the extended immunisation programme for high-risk groups, PCV13 and 23PPV are funded for eligible individuals, as shown in Table 16.3, Table 16.4 and Table 16.5. Because the recommended schedule depends on the age of the individual at diagnosis, the tables have been organised into age groups .
The PCV13 and 23PPV funding restrictions are as follows. See Table 16.3, Table 16.4 and Table 16.5 for the eligible conditions and dosing requirements.
PCV13
All high-risk infants are recommended to receive at least three doses of a PCV vaccine, with at least one dose after 12 months of age. Change from PCV10 to PCV13 as soon as the infant is diagnosed as being at high risk.
- Two doses of PCV13 are funded for high-risk children aged from 12 months and under 18 years who have previously received two or three doses of PCV10.
- Up to four doses of PCV13 are funded for vaccination or re-vaccination of high-risk children aged under 5 years.
- Up to four doses of PCV13 are funded for vaccination or re-vaccination of eligible individuals aged 5 years and older.
23PPV
Give up to four doses of PCV13c |
|
23PPV |
Give a maximum of 3 doses of 23PPV in a lifetime, a minimum of 5 years apart. The first 23PPV dose is given at least 8 weeks after PCV13, the 2nd a minimum of 5 years later, and the 3rd dose at age 65 years. |
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How Many Doses Of Pneumovax 23 Are Needed
All adults 65 years of age or older should receive one dose of PPSV23 5 or more years after any prior dose of PPSV23, regardless of previous history of vaccination with pneumococcal vaccine. No additional doses of PPSV23 should be administered following the dose administered at 65 years of age or older.
What Is Pneumococcal Disease
Pneumococcal disease is an infection caused by the bacteria Streptococcus pneumoniae or pneumococcus. People can be infected with the bacteria, or they can carry it in their throat, and not be ill. Those carriers can still spread it, primarily in droplets from their nose or mouth when they breathe, cough, or sneeze.
Depending on what organ or part of the body is infected, pneumococcal disease will cause any of several serious illnesses, including:
- Bacterial meningitis, an infection of the covering of the brain and spinal cord that can lead to confusion, coma, and death as well as other physical effects, such as blindness or paralysis
- Pneumonia, an infection of the lungs that creates cough, fever, and difficulty breathing
- Otitis media, a middle ear infection that can cause pain, swelling, sleeplessness, fever, and irritability
- Bacteremia, a dangerous infection of the blood stream
- Sinus infections
There are more than 6,000 deaths each year in the U.S. as a result of pneumococcal disease. More than half of those deaths are in adults who, according to CDC recommendations, should have been vaccinated.
In children under age 5, infection with the pneumococcus bacteria results in approximately 480 cases of meningitis and 4,000 cases of bacteremia or other invasive infection per year. A major problem in very young children is that the classic symptoms of meningitis and pneumonia are often not present, making the disease hard to recognize.
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Finding Vaccines For Children
PCV13 is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:
- Pediatric and family practice offices
- Community health clinics
- Health departments
- Other community locations, such as schools and religious centers
You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.
How Do I We Get The Vaccine

In Canada, all provinces and territories provide the pneumococcal conjugate vaccine, starting at 2 months of age. While the exact schedule will depend on where you live, usually two shots are given between 2 and 11 months of age and a booster at 12-15 months. Children at high risk of disease are given three shots , as well as the booster.
Unvaccinated children between 15 months and 5 years old should also get the vaccine. Your doctor or public health unit can tell you the number of shots your child will need and when.
All unvaccinated children and adolescents who are at high risk of serious infection should receive both the conjugate and the polysaccharide vaccine. The polysaccharide vaccine is at given at age 2 or later, with a booster 5 years after the first.
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Recommendations For Use Of Pcv13 And Ppsv23
ACIP recommends use of PCV13 for 1) all children aged 2–59 months and 2) children aged 60–71 months with underlying medical conditions that increase their risk for pneumococcal disease or complications .
No Previous PCV7/PCV13 Vaccination
- The ACIP recommendation for routine vaccination with PCV13 and the vaccination schedules for infants and toddlers through age 59 months who have not received any previous PCV7 or PCV13 doses are the same as those previously published for PCV7 . PCV13 is recommended as a 4-dose series at ages 2, 4, 6, and 12–15 months.
Infants Aged 2–6 Months
- The primary infant series consists of 3 doses of PCV13. Infants receiving their first dose at age 6 months should receive 3 doses of PCV13 at intervals of approximately 8 weeks . The fourth dose is recommended at age 12–15 months and at least 8 weeks after the third dose .
- Newborns should begin the schedule at age 2 months, although the first dose can be administered as early as 6 weeks. For prematurely born infants who are medically stable enough to be vaccinated, PCV13 should be administered at the recommended chronologic age concurrent with other routine vaccinations.
Children Aged 7 Months
Infants Aged 7–11 Months
- Three doses are recommended. The first 2 doses should be administered with an interval of at least 4 weeks between doses. The third dose should be administered at age 12–15 months, at least 8 weeks after the second PCV13 dose.
Children Aged 12–23 Months
Children Aged > 24 Months