Pneumococcal Vaccine: Who Should Get Vaccinated and When?

En Español (Spanish Version)

Pneumococcal disease is an infection caused by the bacterium Streptococcus pneumoniae. It can lead to:

Pneumonia
Bacteremia (infection of the blood)
Middle ear infection
Bacterial meningitis

Streptococcus pneumoniae is spread through contact with a person who has the disease or who carries the bacteria in his throat. This most often occurs through droplets from the nose or mouth of someone with the infection.

There are two types of pneumococcal vaccines:

Pneumococcal conjugate vaccine (PCV)—recommended for infants and toddlers. The PCV13 vaccine, which protects against 13 types of pneumococcal bacteria, replaced the PCV7 vaccine.
Pneumococcal polysaccharide vaccine (PPSV)—recommended for certain children and adults

The vaccines are made from inactivated bacteria. It is given by injection under the skin or into the muscle. The goal of getting a vaccine is that later, when you are exposed to the bacteria, you will not get sick from it.

Who Should Get Vaccinated and When?

PCV

The PCV is routinely given in four doses at 2, 4, 6, and 12-15 months.

If your child has not been vaccinated or missed a dose, talk to the doctor. Depending on your child's age, he may need additional doses. Also, an additional dose may be needed if your child:

Is less than five years old and was given PCV7 (an earlier version of the vaccine)
Has an underlying condition that puts him at higher risk for severe disease

/CIB/Chronic Renal Failure

PPSV

In Children

If your child is aged 2-18 years old and is at high risk, he may need the PPSV, even if he has received the full series of PCV vaccine. High risk includes:

Having certain conditions, such as:
- Heart, lung, or liver disease
- Kidney failure
- Sickle cell disease
- Diabetes
- Cochlear implants
- Cerebrospinal fluid leaks
- HIV or AIDS or other disease the creates a weak immune system
- Damaged spleen or no spleen
Taking medicine that suppresses the immune system

Two doses of PPSV may be needed in some cases.

In Adults

PPSV is recommended for adults:

Aged 65 years and older
Aged 64 years and younger who are at high risk, which includes:
- Having certain conditions, such as:
  - Lung disease (eg, chronic obstructive pulmonary disease, emphysema, asthma)
  - Cardiovascular disease
  - Diabetes
  - Liver disease (eg, cirrhosis)
  - Alcoholism
  - Cochlear implant
  - Cerebrospinal fluid leaks
  - Suppressed immune system (eg, HIV)
  - Sickle cell disease
  - Damaged spleen or no spleen
- Living in a nursing home or long-term care facility
- Being a smoker
- Taking certain medicines (eg, long-term steroids, medicines to treat cancer, radiation therapy) (the vaccine should be given at least 2 weeks before cancer treatment begins)

In some cases, a second dose of PPSV may be needed. For example, another dose after five years may be needed for people aged 19-64 years who have conditions like chronic renal failure or immunocompromising conditions (eg, HIV/AIDS).

Baker CJ, Pickerling LK, Chilton L, et al; Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med. 1 Feb 2011. 154(3):168-173.

Centers for Disease Control and Prevention. Pneumococcal conjugate vaccine. Centers for Disease and Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf. Update April 16, 2010. Accessed January 7, 2011.

Centers for Disease Control and Prevention (CDC). Pneumococcal polysaccharide vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-ppv.pdf. Updated October 2009. Accessed January 7, 2011.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years —United States, 2011. MMWR 2011;60(5).

National Immunization Program. United States Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nip.

Parents’ guide to childhood immunization. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/pneumo/downloads/pg_why_vacc_pneumo.pdf. Accessed February 18, 2008.

Pneumococcal: understanding the disease. National Network for Immunization Information website. Available at: http://www.immunizationinfo.org/vaccines/pneumococcal-disease. Updated March 31, 2010. Accessed January 7, 2011.

Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/mmwr-adult-schedule.pdf. Accessed February 17, 2012.

Vaccine information for the public and health professionals—pneumoccocal vaccine: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/pneumchild/qandavax.asp. Accessed February 18, 2008.

Vaccine information statement: pneumococcal conjugate vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf. Updated April 16, 2010. Accessed February 10, 2012.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm. Updated January 10, 2008. Accessed January 28, 2008.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339.

9/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

1/7/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php:

Nuorti J, Whitney C, Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children—use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine. MMWR Morb Mortal Wkly Rep. 2010;59(34):1102.

Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Licensure of a 13-Valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children. MMWR Recomm Rep. 2010;59(RR-11):1.

Last reviewedJune 2012by Tajender S. Vasu, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Pneumococcal Vaccine: Who Should Get Vaccinated and When?

Who Should Get Vaccinated and When?

PCV

PPSV

In Children

In Adults

What Are the Risks Associated With the Pneumococcal Vaccine?

PCV

PPSV

Who Should Not Get Vaccinated?

PCV

PPSV

What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

What Happens in the Event of an Outbreak?

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