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Pneumococcal Vaccine(Pneumococcal Conjugate Vaccine; PCV; Pneumococcal Polysaccharide Vaccine; PPSV)
What Is Pneumococcal Disease?

Pneumococcal disease is an infection caused by bacteria. It can lead to:

It is spread by person-to-person contact.

What Is the Pneumococcal Vaccine?

There are 2 types of pneumococcal vaccines:

  • Pneumococcal conjugate vaccine (PCV)—Recommended for all children younger than 5 years old, all adults aged 65 years and older, and those aged 6 years and older with certain risk factors or diseases. The PCV13 vaccine protects against 13 types of pneumococcal bacteria.
  • Pneumococcal polysaccharide vaccine (PPSV)—Recommended for certain children and adults, and all adults 65 years old and older. People aged 2-64 years with certain risk factors or diseases should also be given this vaccine. The PCV23 vaccine protects against 23 types of pneumococcal bacteria.

Adults 65 years old and older may receive PCV followed by PPSV. Ask your doctor if you should receive both vaccines.

The vaccines are made from inactivated bacteria. They are 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 4 doses at 2, 4, 6, and 12-15 months. It can also be given to children with high-risk conditions. It is also recommended for all adults aged 65 years and older.

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

  • Is less than 5 years old and was given PCV7, which is an earlier version of the vaccine
  • Has a condition that increases the risk of severe disease
PPSV

The PPSV is given to adults aged 65 years and older.

PPSV is also given to anyone aged 2-64 years who have certain conditions, such as:

PPSV is also given to anyone aged 2-64 years who is taking a drug or treatment that lowers the body's ability to resist infection, such as:

The vaccine should be given at least 2 weeks before cancer treatment begins.

PPSV should also be given to any adult aged 19-64 years old who:

In some cases, a second dose of PPSV may be needed. For example, a second dose is recommended for people 65 and older who got their first dose before they turned 65 and it has been more than 5 years since that dose. A second dose is also recommended for people 2 through 64 who have:

  • A damaged spleen or no spleen
  • Sickle cell disease
  • HIV infection or AIDS
  • Cancer, leukemia, lymphoma, or multiple myeloma
  • Nephrotic syndrome
  • An organ or bone marrow transplant
  • Been taking medication that lowers immunity, such as chemotherapy or long-term steroids

When a second dose is given, it should be 5 years after the first dose.

What Are the Risks Associated With the Pneumococcal Vaccine?
PCV

Generally, all vaccines have a small risk of serious problems. Side effects of PCV include:

  • Redness, tenderness, or swelling at the injection site
  • Fever
  • Drowsiness
  • Loss of appetite
  • Irritability

Acetaminophen is sometimes given to reduce pain and fever that may occur after getting a vaccine. Giving the medication at the time of the shot may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.

PPSV

Half of the people who get the vaccine have mild side effects. However, developing the disease is much more likely to cause serious problems than getting the vaccine. Side effects may include:

  • Redness or pain at the injection site
  • Fever
  • Muscle aches
  • Severe allergic reactions—rare
Who Should Not Get Vaccinated?
PCV

Children who should not receive the vaccine are those who:

  • Have had a life-threatening allergic reaction to a previous dose of PCV
  • Have had a severe allergy to one of the vaccine's parts
  • Are very ill
PPSV

You should not receive the PPSV if you:

  • Had a life-threatening allergic reaction to a previous dose of PPSV
  • Had a severe allergy to one of the vaccine's components
  • Are very ill
What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

You can prevent pneumococcal disease if you:

  • Avoid close contact with people who have infections.
  • Wash your hands regularly to reduce your risk of infection.
What Happens in the Event of an Outbreak?

In the event of an outbreak, all people who are eligible for a vaccine should receive it.

WHERE CAN I GET MORE INFORMATION?

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Vaccines & Immunizations
Centers for Disease Control and Prevention
http://www.cdc.gov

References:

Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules. Updated January 26, 2015. Accessed November 11, 2015.

Kobayashi M, Bennett NM, Gierke R, et al. Intervals between PCV13 and PPSV23 vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2015;64(34):944-947.

Pneumococcal conjugate vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.pdf. Updated November 5, 2015. Accessed November 11, 2015.

Pneumococcal disease. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/pneumococcal. Updated January 12, 2015. Accessed November 11, 2015.

Pneumococcal polysaccharide vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/ppv.pdf. Updated April 24, 2015. Accessed November 11, 2015.

Pneumococcal: understanding the disease. National Network for Immunization Information website. Available at: http://www.immunizationinfo.org/vaccines/pneumococcal-disease. Accessed November 11, 2015.

Pneumococcal vaccination. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm?s_cid=cs_797. Updated July 21, 2015. Accessed November 11, 2015.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Prymula R, Siegrist C, Chilbek 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: 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:
Nuorti J, Whitney C, et al. 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 reviewed November 2015 by David L. Horn, 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.

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