Pneumococcal Vaccination: Summary of Who and When to Vaccinate

There are two types of pneumococcal vaccines available in the United States:

• Pneumococcal conjugate vaccine (PCV13 or Prevnar13®)
• Pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®)

CDC recommends pneumococcal vaccination for all infants and children younger than 2 years of age and all adults 65 years or older. In certain situations, other children and adults should also receive pneumococcal vaccines. Below is more information about who should receive each type of pneumococcal vaccine.

Summary of PCV13 Vaccine Recommendations by Age Group

Infants and Children younger than 2 Years Old

• PCV13 is routinely given to infants as a series of 4 doses, one dose at each of these ages: 2 months, 4 months, 6 months, and 12 through 15 months.
• Children who miss their shots or start the series later should still get the vaccine. The number of doses recommended and the intervals between doses will depend on the child's age when vaccination begins. Ask your healthcare provider for details.

Children 2 through 18 Years

• Healthy children 24 months through 4 years of age who are unvaccinated or have not completed the PCV13 series should get 1 dose.
• Children 24 months through 5 years of age with certain medical conditions (listed below) should get 1 or 2 doses of PCV13 if they have not already completed the 4-dose series.
• Children 6 through 18 years of age with certain medical conditions (listed below) should get 1 dose of PCV13 if they have not previously received this vaccine, regardless of whether they have previously received the 7-valent pneumococcal conjugate vaccine (PCV7) or the 23-valent pneumococcal polysaccharide vaccine (PPSV23).
  • Chronic heart disease, particularly cyanotic congenital heart disease and cardiac failure
  • Chronic lung disease, including asthma if treated with high-dose oral corticosteroid therapy
  • Diabetes mellitus
  • Cerebrospinal fluid leaks
  • Cochlear implant(s)
  • Sickle cell disease and other hemaglobinopathies
  • Congenital or acquired asplenia, or splenic dysfunction
  • HIV infection
  • Chronic renal failure and nephrotic syndrome
  • Diseases associated with treatment with immunosuppresive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; or solid organ transplantation
  • Congenital immunodeficiency (includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)

Adults 19 through 64 Years

• A single dose of PCV13 should be given to adults 19 years or older with certain medical conditions, and who have not previously received PCV13. Medical conditions include:
  • Cerebrospinal fluid leaks
  • Cochlear implant(s)
  • Sickle cell disease and other hemaglobinopathies
  • Congenital or acquired asplenia
  • Congenital or acquired immunodeficiencies
  • HIV infection
  • Chronic renal failure and nephrotic syndrome
  • Leukemia or lymphoma
  • Hodgkin disease
  • Generalized malignancy
  • Iatrogenic immunosuppression (diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy)
  • Solid organ transplant
  • Multiple myeloma
• Adults 19 years or older with one of the above listed conditions who have not received any pneumococcal vaccine, should get a dose of PCV13 first and should also continue to receive the recommended doses of PPSV23.
• Adults 19 years or older who have previously received one or more doses of PPSV23, and have one of the above listed conditions should also receive a dose of PCV13 and should continue to receive the remaining recommended doses of PPSV23.

Adults 65 Years or Older

• Adults 65 years or older who have not previously received PCV13, should receive a dose of PCV13.

 

Summary of PPSV23 Vaccine Recommendations by Age Group

People 2 through 64 Years

• Anyone 2 through 64 years of age who has one of the following chronic medical conditions should get 1 dose of PPSV23:
  • Chronic heart disease, including congestive heart failure and cardiomyopathies
  • Chronic lung disease, including chronic obstructive pulmonary disease, emphysema, and asthma
  • Diabetes mellitus
  • Cerebrospinal fluid leaks
  • Cochlear implant(s)
  • Alcoholism
  • Chronic liver disease
• Anyone 2 through 64 years of age who has one of the following immunocompromising conditions should get 2 doses of PPSV23, 5 years apart:
  • Congenital or acquired immunodeficiencies (includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)
  • HIV infection
  • Chronic renal failure or nephrotic syndrome
  • Leukemia or lymphoma
  • Hodgkin disease
  • Generalized malignancy
  • Iatrogenic immunosuppression (diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy)
  • Solid organ transplant
  • Multiple myeloma
• Adults 19 through 64 years of age who smoke should get 1 dose of PPSV23.

Adults 65 Years or Older

• All adults 65 years or older should get 1 dose of PPSV23. Adults who received one or two doses of PPSV23 before age 65 should receive one final dose of the vaccine at age 65 or older once 5 years have elapsed since their most recent PPSV23 dose.

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