Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and should be started on an immunization schedule appropriate for their age and risk factors. Pneumococcal vaccines may be given, regardless of possible previous receipt of the vaccines, as adverse events associated with repeated immunization have not been demonstrated. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
How Many Doses Of Pcv13 Can An Adult Get In A Lifetime Who/when
CDC recommends adults receive 1 dose of PCV13, if indicated and if they have not received PCV13 previously . In addition, adults age 65 or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant can choose to receive PCV13 based on shared clinical decision-making. However, if an adult received a dose of PCV13 prior to turning 65 years of age , they should not receive a dose of PCV13 when they turn 65.
Vaccines For Children Program
The Vaccines for Children Program provides vaccines to children whose parents or guardians may not be able to afford them. A child is eligible if they are younger than 19 years old and meets one of the following requirements:
- Medicaid-eligible
- American Indian or Alaska Native
- Underinsured
If your child is VFC-eligible, ask if your doctor is a VFC provider. For help in finding a VFC provider near you, contact your state or local health departments VFC Program Coordinator or call CDC at 1-800-CDC-INFO .
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Questions To Ask Your Doctor
- When should I make an appointment to get each type of pneumococcal vaccine?
- Should I still get the vaccines if Ive recently had pneumonia?
- Should I wait to turn 65 before I get each dose of pneumococcal vaccines?
- If I have a negative reaction to one type of pneumococcal vaccine, am I likely to have that same reaction to the other?
Funding was provided for these pneumococcal resources through an unrestricted grant from Pfizer Independent Grant for Learning and Change .
Who Should Not Get These Vaccines

Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below specific to pneumococcal vaccines and ask your or your childs doctor for more information.
Children younger than 2 years old should not get PPSV23. In addition, tell the person who is giving you or your child a pneumococcal conjugate vaccine if:
You or your child have had a life-threatening allergic reaction or have a severe allergy.
- Anyone who has had a life-threatening allergic reaction to any of the following should not get PCV13:
- A shot of this vaccine
- An earlier pneumococcal conjugate vaccine called PCV7
- Any vaccine containing diphtheria toxoid
You or your child are not feeling well.
- People who have a mild illness, such as a cold, can probably get vaccinated. People who have a more serious illness should probably wait until they recover. Your or your childs doctor can advise you.
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What Are The Most Common Side Effects Of Pneumovax 23 And Prevnar 13
Side effects with pneumococcal vaccines are usually mild and go away on their own within a few days.
Common side effects of Prevnar 13 include:
-
Injection site pain
-
Fever
Common side effects of Pneumovax 23 include:
-
Injection site pain
-
Fever
-
Muscle aches
-
Fatigue
Be sure to talk with your doctor if you experience any of these symptoms for a prolonged period of time.
Who Should Get The Pneumococcal Vaccine And When Should It Be Given
The PCV7 vaccine that covered seven strains of pneumococcal bacteria, has now been updated to the PCV13 vaccine, which covers 13 strains. A PCV series begun with PCV7 should be completed with PCV13. A single additional dose of PCV13 is recommended for all children 14â59 months who have received an age-appropriate series of PCV7 and for all children 60â71 months with underlying specific medical conditions who have received an age-appropriate series of PCV7.
The PCV vaccine is recommended for the following children:
- All infants younger than 24 months should receive four doses of the vaccine, the first one at 2 months. The next two shots should be given at 4 months and 6 months, with a final booster that should be given at 12 to 15 months. Children who do not get their shot at these times should still get the vaccine. The number of doses and time between doses will depend on the child’s age.
- Healthy children ages 2 through 4 years who did not complete the four doses should receive one dose of the vaccine.
The PPSV vaccine is recommended for any adult ages 19 through 64 who smokes or has asthma and anyone ages 2 through 64 who is taking a drug or treatment that affects the body’s immune system. Examples would be long-term use of steroids, chemotherapy, or radiation therapy.
In addition, anyone ages 2 through 64 who has one of the following health conditions that affect the immune system should be vaccinated with PPSV:
- leaks of cerebrospinal fluid
- cochlear implant
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Concurrent Administration Of Vaccines
Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
Recommendations For Adults With Previous Ppsv23 Vaccinations
Adults 65 years of age or older who do not have an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak and who have not previously received PCV13 may receive a dose of PCV13. Based on , clinicians and these older adults can discuss PCV13 vaccination to decide if it is appropriate. For those who choose to receive PCV13, give the dose of PCV13 at least 1 year after the most recent PPSV23 dose. Additionally, all adults 65 years or older should receive 1 dose of PPSV23 after age 65 years old regardless of their previous PPSV23 vaccination history. Doses of PPSV23 should be spaced 5 years apart from each other.
Adults 19 years of age or older who previously received one or more doses of PPSV23 should receive a dose of PCV13 at least one year after administration of the most recent PPSV23 dose if they have
- Immunocompromising conditions
- CSF leaks
- Cochlear implants
For those who require an additional dose of PPSV23, administer it no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23.
Pneumococcal Vaccine Timing for Adults pdf icon provides a summary of this detailed guidance.
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Complications Of Pneumonia Caused By Covid
Because pneumonia causes the alveoli in the lungs to fill with pus and fluid, breathing can be painful and difficult.
Pneumonia can cause serious health complications, including:
Because COVID-19 attacks the lungs, it would make sense that having COVID-19 would cause lung complications. As of yet, not enough data are available to support this conclusion.
However, as noted above, research does show that COVID-19 can cause severe illness, including pneumonia that can be fatal. A 2020 study by the CDC found that among a group of people with COVID-19, about 70% had complications from pneumonia. Also, people with COVID-19 were twice as likely to get pneumonia compared to people with the flu.
Regarding long-lasting complications from COVID-19, it is still too soon to say for sure whether “long-haulers” are more likely to have underlying chronic medical conditions.
How Do We Know The Vaccine Is Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once they’re in use, the safety of vaccines continues to be monitored by the MHRA.
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Are You 65 Or Older Get Two Vaccinations Against Pneumonia
- By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
If you or a loved one is age 65 or older, getting vaccinated against pneumonia is a good idea so good that the Centers for Disease Control now recommends that everyone in this age group get vaccinated against pneumonia twice.
This new recommendation is based on findings from a large clinical trial called CAPiTA, which were published today in The New England Journal of Medicine.
Streptococcus pneumoniae, sometimes just called pneumococcus, is a common bacterium that can cause serious lung infections like pneumonia. It can also cause invasive infections of the bloodstream, the tissues covering the brain and spinal cord , and other organs and tissues. Older individuals are especially prone to being infected by Pneumococcus, and these infections are often deadly.
The dark spots are pneumonia-causing Streptococcus pneumoniae bacteria isolated from the blood of an infected person.
One caveat is that while PCV13 is effective in preventing pneumonia caused by S. pneumoniae, it does not prevent pneumonia caused by viruses or other bacteria.
Who Needs A Pneumococcal Vaccination

The pneumococcal vaccine is available in Scotland for all people aged 65 years and over.
It may also be available if you’re under 65 and fall under one of the following risk groups, or have one of the following serious medical conditions:
- problems with the spleen, either because the spleen has been removed or doesn’t work properly
- chronic respiratory diseases, including chronic obstructive pulmonary disease , chronic bronchitis, and emphysema
- serious heart conditions
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Whats The Difference Between Pcv13 And Ppsv23
PCV13 | |
helps protect you against 13 different strains of pneumococcal bacteria | helps protect you against 23 different strains of pneumococcal bacteria |
usually given four separate times to children under two | generally given once to anyone over 64 |
generally given only once to adults older than 64 or adults older than 19 if they have an immune condition | given to anyone over 19 who regularly smokes nicotine products like cigarettes or cigars |
- Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
- Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
- Dont get the shots too close together. Youll need to wait about a year in between each shot.
- Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.
- a vaccine made with diphtheria toxoid
- another version of the shot called PCV7
- any previous injections of a pneumonia shot
- are allergic to any ingredients in the shot
- have had severe allergies to a PPSV23 shot in the past
- are very sick
How Effective Is Each Vaccine
Vaccines help protect against disease, but no vaccine is 100% effective.
Studies show that at least one dose of Prevnar 13 protects 80% of babies from serious pneumococcal infections, 75% of adults age 65 and older from invasive pneumococcal disease , and 45% of adults age 65 and older from pneumococcal pneumonia.
Studies show that one dose of Pneumovax 23 protects 50% to 85% of healthy adults against invasive pneumococcal disease.
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Who Should Not Get Pneumovax 23 Or Prevnar 13
Children younger than 2 years of age should not get Pneumovax 23. In addition, while there is no evidence that Pneumovax 23 is harmful to pregnant women or their babies, as a precaution, women who need Pneumovax 23 should get it before becoming pregnant, if possible.
Before you get either Prevnar 13 or Pneumovax 23, tell your health provider if you have had any life-threatening allergic reaction to or have a severe allergy to pneumococcal vaccines or any vaccine containing diphtheria toxoid . Also, tell your health provider if you are not feeling well. If you have a minor illness like a cold, you can probably still get vaccinated, but if you have a more serious illness, you should probably wait until you recover.
Common And Local Adverse Events
Pneumococcal conjugate vaccine
Studies of Pneu-C-13 vaccine indicated that irritability decreased appetite increased or decreased sleep and pain, swelling and redness at the injection site after the toddler dose and in older children, are common side effects. Low grade fever occurred in 20% to 30% or more of vaccine recipients. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38°C occurring in approximately 3% of vaccine recipients.
Pneumococcal polysaccharide vaccine
Reactions to Pneu-P-23 vaccine are usually mild. Soreness, redness and swelling at the injection site occur in 30% to 60% of vaccine recipients and more commonly follow SC administration than IM administration. Occasionally, low grade fever may occur. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. However, severe injection site reactions, including reports of injection site cellulitis and peripheral edema in the injected extremity, have been documented rarely with Pneu-P-23 vaccine in post-marketing surveillance, even with the first dose. Multiple re-vaccinations are not recommended refer to Booster doses and re-immunization.
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Can I Administer Ppsv23 And Pcv13 At The Same Office Visit
No, never give PPSV23 and PCV13 together. The recommended order for the two vaccines, if possible, is to give PCV13 first followed by PPSV23 later. The interval between administrations depends on the age of the patient, the indication for giving it, and which vaccine you administer first. See Pneumococcal Vaccine Timing for Adults pdf icon for additional details.
Where Can I Find These Vaccines
Your doctors office is usually the best place to receive recommended vaccines for you or your child.
PCV13 is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:
- Pediatric and family practice offices
- Community health clinics
If your doctor does not have pneumococcal vaccines for adults, ask for a referral.
Pneumococcal vaccines may also be available for adults at:
- Pharmacies
- Health departments
- Other community locations, such as schools and religious centers
Federally funded health centers can also provide services if you do not have a regular source of health care. Locate one near youexternal icon. You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.
When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps doctors at future encounters know what vaccines you or your child have already received.
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Preventing The Spread Of Pneumonia
You can help prevent the spread of a pneumonia by taking some simple hygiene precautions.
These include:
- washing your hands regularly and thoroughly, particularly after touching your nose and mouth, and before handling food
- coughing and sneezing into a tissue, then throwing it away immediately and washing your hands
- not sharing cups or kitchen utensils with others
Your Good Health: You Can Get Pneumonia Even When Vaccinated

Dear Dr. Roach: When I was 55, my doctor recommended that I have the pneumonia vaccination, and a booster a couple of years ago. I am 72 now. Is it likely Hillary Clinton would have got one? Can you get pneumonia after having the vaccination? If so, why would it be recommended, and are they harmful?
S.M.
I dont know whether Mrs. Clinton was vaccinated. However, expert groups recommend vaccination. The current recommendation from the U.S. Advisory Committee on Immunization Practices is to get the PCV13 at age 65, followed by a dose of PPSV23 six to 12 months later. Adults over 18 also should receive these two vaccines if they have a condition that compromises the immune system, or certain other medical conditions. Some experts recommend only the Pneumovax for healthy elderly.
No vaccine is perfect, so it is still possible to get pneumococcal pneumonia after vaccination. There are many other types of pneumonia caused by organisms other than the one covered by the vaccine.
The best estimate is that the vaccine prevents 50 to 80 per cent of severe pneumococcal disease. The most common side effects are a sore or swollen arm. Serious reactions are rare. Because of the significant benefit and small risk of harm, I recommend at least the PPSV23 pneumococcal vaccine for those over 65.
S.C.
The second issue is whether it is safe to do both cataract surgeries at the same time.
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