The Pneumonia Vaccine: What It Is and Who Should Get It

What does the pneumococcal vaccine protect against?

Pneumococcal vaccines target Streptococcus pneumoniae, a bacterium that causes bacterial pneumonia, meningitis, and bacteremia (bloodstream infection). These diseases are serious at any age but are more likely to be severe or fatal in older adults and people with weakened immune systems. S. pneumoniae is the leading identifiable bacterial cause of community-acquired pneumonia in adults in the United States 3Ref 3Issa AN, Wodi AP, Moser CA, Cineas S (2025).Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2025.Childhood pneumococcal conjugate vaccination schedule starting in infancy; S. pneumoniae as leading bacterial cause of community-acquired pneumonia framing..

What is the difference between PCV and PPSV23?

Two categories of pneumococcal vaccine are currently in use 1Ref 1Kobayashi M, Farrar JL, Gierke R, Leidner AJ, Campos M, Tiwari TSP, Marlow M, Wodi AP, Patel M (2022).Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022.Updated ACIP recommendations for PCV15 and PCV20 in adults; adults 65+ and risk-based groups 19–64; guidance on sequencing with PPSV23.2Ref 2Kobayashi M, Pilishvili T, Farrar JL, et al. (2023).Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.Comprehensive ACIP pneumococcal recommendations for all adults including conditions qualifying for early vaccination, universal recommendation at 65+, and product selection guidance.:

• Conjugate vaccines (PCVs) — including PCV15, PCV20, and PCV21 — are designed to trigger a strong immune response and are effective across a broad range of pneumococcal strains. Newer conjugate vaccines now cover enough strains that, in many cases, a single vaccine replaces what used to be a two-shot sequence.
• PPSV23 is an older polysaccharide vaccine covering 23 strains. It is still used in certain combinations for specific groups.

Your clinician will know which is appropriate based on what is currently recommended and what you have received before.

Who should get a pneumococcal vaccine?

Three main groups are prioritized 1Ref 1Kobayashi M, Farrar JL, Gierke R, Leidner AJ, Campos M, Tiwari TSP, Marlow M, Wodi AP, Patel M (2022).Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022.Updated ACIP recommendations for PCV15 and PCV20 in adults; adults 65+ and risk-based groups 19–64; guidance on sequencing with PPSV23.2Ref 2Kobayashi M, Pilishvili T, Farrar JL, et al. (2023).Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.Comprehensive ACIP pneumococcal recommendations for all adults including conditions qualifying for early vaccination, universal recommendation at 65+, and product selection guidance.:

Children under 2. All receive pneumococcal conjugate vaccine as part of the routine childhood schedule, starting in infancy.

Adults 65 and older. All adults in this group who have not already completed the series under current guidelines should receive pneumococcal vaccination 2Ref 2Kobayashi M, Pilishvili T, Farrar JL, et al. (2023).Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.Comprehensive ACIP pneumococcal recommendations for all adults including conditions qualifying for early vaccination, universal recommendation at 65+, and product selection guidance.. The specific product depends on what was previously received — your clinician or pharmacist can apply the current recommendation.

Adults 19–64 with certain conditions. These include diabetes, chronic heart or lung disease, chronic liver disease, kidney disease, cochlear implants, cerebrospinal fluid leaks, immunocompromising conditions (including HIV), asplenia, immunosuppressive therapy, and current smoking 1Ref 1Kobayashi M, Farrar JL, Gierke R, Leidner AJ, Campos M, Tiwari TSP, Marlow M, Wodi AP, Patel M (2022).Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022.Updated ACIP recommendations for PCV15 and PCV20 in adults; adults 65+ and risk-based groups 19–64; guidance on sequencing with PPSV23.2Ref 2Kobayashi M, Pilishvili T, Farrar JL, et al. (2023).Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.Comprehensive ACIP pneumococcal recommendations for all adults including conditions qualifying for early vaccination, universal recommendation at 65+, and product selection guidance..

What if you already had a pneumonia vaccine years ago?

The recommendations have evolved, and which vaccines count toward a 'complete' status depends on the type received and when. If you had only PPSV23, you may still benefit from a conjugate vaccine. If you received an older PCV series (PCV13), the newer higher-valent vaccines may now be recommended as follow-up 1Ref 1Kobayashi M, Farrar JL, Gierke R, Leidner AJ, Campos M, Tiwari TSP, Marlow M, Wodi AP, Patel M (2022).Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022.Updated ACIP recommendations for PCV15 and PCV20 in adults; adults 65+ and risk-based groups 19–64; guidance on sequencing with PPSV23..

Bring your vaccination records — or your best recollection — to your clinician or pharmacist. If records are lost, getting revaccinated is generally safe.

What should you expect from the shot?

Pneumococcal vaccines are given as a single injection, usually in the upper arm. The most common side effects are arm soreness, redness at the injection site, and occasionally mild fatigue or a low-grade fever for a day or two. Serious allergic reactions are rare. The vaccine does not contain live bacteria and cannot cause pneumonia.

How do special health situations change the plan?

Asplenia or sickle cell disease. The spleen plays a key role in clearing encapsulated bacteria like S. pneumoniae. People without a functional spleen are particularly vulnerable and often require a more complete or earlier vaccine schedule 1Ref 1Kobayashi M, Farrar JL, Gierke R, Leidner AJ, Campos M, Tiwari TSP, Marlow M, Wodi AP, Patel M (2022).Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022.Updated ACIP recommendations for PCV15 and PCV20 in adults; adults 65+ and risk-based groups 19–64; guidance on sequencing with PPSV23..

Immunocompromising conditions or therapy. May require an accelerated or expanded schedule; the choice of vaccine type and timing relative to immunosuppressive therapy warrants individual guidance.

Cost and access. For adults 65 and older, pneumococcal vaccines are typically covered by Medicare Part B. Most private insurance covers them for recommended age groups. Many pharmacies administer them without a separate appointment.