Pneumococcal vaccines

Pneumococcus is a type of bacteria that can cause several severe infections, including pneumonia, meningitis, and blood infections (sepsis). These infections can be serious and even life-threatening, especially in people with impaired immune systems, older adults, and children younger than 2 years of age.

Doctors use two types of pneumococcal vaccines for routine immunization: pneumococcal conjugate (PCV) or pneumococcal polysaccharide (PPSV). The type of vaccine used depends on a person's age.

Pneumococcal conjugate vaccine (PCV)

Pneumococcal conjugate vaccine is approved for infants and toddlers. Children who are vaccinated when they are infants will be protected when they are at greatest risk for serious disease.

Who should get the vaccine and when?

• Children under 2 years of age.
  • The routine schedule for pneumococcal conjugate vaccine is 4 doses, one dose at each of these ages:
    • 2 months
    • 6 months
    • 4 months
    • 12-15 months

  Note: Children who weren't vaccinated at these ages can still get the vaccine. The number of doses needed depends on the child's age. Ask your health care provider for details.

• Children ages 24 to 59 months (2 years through 4 years of age)
  • One dose is given to healthy children in this age group who did not get all the doses before.
  • Children in this age group who have medical conditions and did not get all the doses before may need 1 or 2 doses. This includes children who:
    • Have sickle cell disease.
    • Have a damaged spleen or no spleen.
    • Have HIV/AIDS.
    • Have other diseases that affect the immune system, such as diabetes, cancer, or liver disease.
    • Take medicines that affect the immune system, such as chemotherapy or steroids.
    • Have chronic heart or lung disease.
  • The vaccine should be considered for all other children under 5 years, especially those at higher risk of serious pneumococcal disease. This includes children who:
    • Are under 3 years of age.
    • Are of Alaska Native, American Indian or African American descent.
    • Attend group day care.

  Note: The number of doses needed depends on the child's age. Ask your health care provider for more details.

Pneumococcal conjugate vaccine may be given at the same time as other vaccines.

Some children should not get pneumococcal conjugate vaccine or should wait.

• Children should not get pneumococcal conjugate vaccine if they had a serious (life-threatening) allergic reaction to a previous dose of this vaccine, or have a severe allergy to a vaccine component. Tell your health-care provider if your child has ever had a severe reaction to any vaccine, or has any severe allergies.
• Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting the vaccine.

Side effects of PCV are mild and include:

• Redness at the injection site.
• Irritability.
• Drowsiness.
• Decreased appetite.
• Slight fever.

Pneumococcal polysaccharide vaccine (PPSV)

The pneumococcal polysaccharide vaccine (PPSV) protects against 23 types of pneumococcal bacteria. Most healthy adults who get the vaccine develop protection to most or all of these types within 2 to 3 weeks of getting the shot.Very old people, children under 2 years of age, and people with some long-term illnesses might not respond as well or at all.

Who should get PPSV?

• All adults 65 years of age or older
• Anyone over 2 years of age who has a long-term health problem, such as:
  • Heart disease
  • Lung disease
  • Sickle cell disease
  • Diabetes
  • Alcoholism
  • Cirrhosis
  • Leaks of cerebrospinal fluid
• Anyone over 2 years of age who has a disease or condition that lowers the body's resistance to infection, such as:
  • Hodgkin's disease
  • Lymphoma, leukemia
  • Kidney failure
  • Multiple myeloma
  • Nephrotic syndrome
  • HIV infection or AIDS
  • Damaged spleen, or no spleen
  • Organ transplant
• Anyone over 2 years of age who is taking any drug or treatment that lowers the body's resistance to infection, such as:
  • Long-term steroids
  • Certain cancer drugs
  • Radiation therapy
• Adults ages 19 to 64 who smoke cigarettes.

How many doses of PPSV are needed?

Usually one dose of PPSV is all that is needed. However, under some circumstances a second dose may be given.

• A second dose is recommended for those people aged 65 and older who got their first dose when they were under 65, if 5 or more years have passed since that dose.
• A second dose is also recommended for people who:
  • Have a damaged spleen or no spleen.
  • Have sickle-cell disease.
  • Have HIV infection or AIDS.
  • Have cancer, leukemia, lymphoma, multiple myeloma.
  • Have kidney failure.
  • Have nephrotic syndrome.
  • Have had an organ or bone marrow transplant.
  • Are taking medicine that lowers immunity (such as chemotherapy or long-term steroids).

Children 10 years old and younger may get this second dose 3 years after the first dose. Those older than 10 should get it 5 years after the first dose.

Other facts about getting the PPSV vaccine

Otherwise healthy children who often get ear infections, sinus infections, or other upper respiratory diseases do not need to get PPSV because of these conditions.

PPSV may be less effective in some people, especially those with lower resistance to infection. But these people should still be vaccinated, because they are more likely to get seriously ill from pneumococcal disease.

Pregnancy: The safety of PPSV for pregnant women has not yet been studied. There is no evidence that the vaccine is harmful to either the mother or the fetus, but pregnant women should consult with their doctor before being vaccinated. Women who are at high risk of pneumococcal disease should be vaccinated before becoming pregnant, if possible.

PPSV may cause mild side effects, such as redness or pain where you receive the shot. Fever and muscle aches are rare side effects.