Pneumococcal vaccines are preventive vaccines that help protect against infections caused by Streptococcus pneumoniae (pneumococcus) bacteria. These infections include pneumonia, meningitis, bloodstream infection (bacteremia), and ear infections. The vaccines work by stimulating the immune system to develop protection before exposure to the bacteria. They do not treat an existing infection. They are prescription vaccines administered by a healthcare professional. Two types are used: pneumococcal conjugate vaccines (PCV) and the pneumococcal polysaccharide vaccine (PPSV23).

Therapeutic Class: Preventive vaccine against pneumococcal (Streptococcus pneumoniae) diseases.

Pharmacological Class: Pneumococcal conjugate vaccine (bacterial capsule sugars linked to a carrier protein) and pneumococcal polysaccharide vaccine (purified bacterial capsule sugars).

Drug Family: Pneumococcal vaccines.

ATC Classification: J07AL (Pneumococcal vaccines). Conjugate vaccines are classified under J07AL02.

Approved:

• Prevention of invasive pneumococcal disease, such as meningitis and bloodstream infection, caused by vaccine-covered pneumococcal types.

• Prevention of pneumonia caused by vaccine-covered pneumococcal types.

• Prevention of middle ear infection (otitis media) in infants and young children, for vaccines labelled for this use.

Commonly used for:

• Routine vaccination of infants and young children. In India's Universal Immunization Programme (UIP), PCV is given at 6 weeks, 14 weeks, and as a booster at 9 months.

• Vaccination of older adults and of adults with long-term health conditions, as advised by their doctor.

• Catch-up vaccination of children who missed doses, as advised by their doctor.

Off-label use (only under medical guidance):

• No routine off-label therapeutic use. The vaccine is preventive and does not treat existing pneumonia or other pneumococcal infections.

• Use outside the age group approved for a specific brand in India (for example, Prevenar 20 is approved in India for adults aged 18 years and older only) should be considered only on a doctor's advice.

• Intramuscular injection: 0.5 mL suspension in a prefilled syringe or a vial. Some government programme presentations are multi-dose vials.

• Available as 10-valent, 13-valent, and 20-valent conjugate vaccines (PCV10, PCV13, PCV20) and a 23-valent polysaccharide vaccine (PPSV23), depending on the brand.

• The number in the name shows how many pneumococcal types the vaccine covers.

Pneumococcal vaccines contain parts of the outer coat (capsule) of the pneumococcus bacteria. They do not contain live bacteria and cannot cause pneumococcal disease. In conjugate vaccines, these capsule sugars are attached to a carrier protein. This helps the immune system, including that of infants, build stronger protection and remember the bacteria for the future. The polysaccharide vaccine contains purified capsule sugars only, and it is not used in children younger than 2 years. Protection is limited to the pneumococcal types included in the vaccine, so different vaccines cover different numbers of types.

Infants and young children (India):

• National programme (UIP): 2 primary doses at 6 weeks and 14 weeks of age, with a booster at 9 months of age. The two primary doses should be at least 8 weeks apart.

• Private schedules may differ by brand and by the paediatrician's advice (for example, 3 primary doses followed by a booster). Follow the schedule your child's doctor recommends.

Delayed doses: Give the missed dose at the next visit. Under the national programme, a child older than 1 year can receive due doses only if at least one dose was given before the first birthday. Healthy children who fall behind may be offered catch-up doses by their doctor.

Adults:

• Prevenar 20 (PCV20): a single dose for adults aged 18 years and older. The need for a repeat dose has not been established.

• Adults who have received PCV13 or PPSV23 earlier may need a further dose. The timing (usually at least 1 year after the earlier dose) depends on which vaccine was used and on the person's health conditions. Your doctor will decide.

• PPSV23: usually a single 0.5 mL dose for people aged 2 years and older, used as advised by the doctor.

Route: Intramuscular injection, usually into the upper arm (deltoid muscle) in older children and adults, and into the outer thigh in infants. PPSV23 may also be given under the skin (subcutaneously).

Missed dose: Receive the missed dose as soon as possible. The vaccination series usually does not need to be restarted.

Overdose: An overdose is unlikely because the vaccine is supplied as a single measured dose. Seek medical advice if an extra dose is accidentally given.

Common:

• Pain, redness, swelling, or tenderness at the injection site.

• Mild fever or chills.

• Tiredness.

• Headache.

• Muscle aches or joint pain.

• In infants and young children: irritability, sleepiness, and reduced appetite.

These effects usually go away within 1 to 3 days.

Serious:

• Severe allergic reactions (rare).

• Fainting after vaccination.

• Seizures linked to fever in young children (uncommon). The risk may be higher if the vaccine is given at the same time as an inactivated influenza vaccine.

Emergency symptoms: Seek immediate medical attention if you or your child develops:

• Difficulty breathing.

• Swelling of the face, lips, or throat.

• Hives or severe rash.

• Fast heartbeat, dizziness, or weakness.

• Loss of consciousness or a seizure.

Recovery advice: Remain seated or lying down for about 15 minutes after vaccination, especially if you have a history of fainting. For pain or fever, paracetamol can be used as advised by your doctor. For infants, ask the paediatrician for the correct dose.

• Pregnancy: Data are limited. Vaccination during pregnancy is considered only when the benefit outweighs the risk, as advised by a healthcare provider.

• Breastfeeding: It is not known whether the vaccine passes into breast milk. Discuss with your doctor.

• Liver disease and kidney disease: Chronic liver and kidney disease increase the risk of pneumococcal infection, so vaccination is advised for these groups.

• Elderly: Older adults are at higher risk of serious pneumococcal disease. Vaccination decisions should be based on age, health conditions, and earlier pneumococcal vaccines received.

• Children: PPSV23 is not for children younger than 2 years. Prevenar 20 is not approved in India for people younger than 18 years. Very premature infants may need breathing monitoring for 48 to 72 hours after the first doses; vaccination should not be withheld for this reason.

• Immunosuppressive medicines (such as steroids, chemotherapy, and some biologic medicines) may reduce the immune response to the vaccine.

• Pneumococcal vaccines can generally be given with other routine vaccines at the same visit, using different injection sites. They must not be mixed in the same syringe.

• The vaccine can be given with a seasonal flu vaccine. In young children, giving it together with an inactivated flu vaccine may slightly raise the risk of fever-related seizures, so ask the paediatrician.

• The vaccine can be given with a COVID-19 mRNA vaccine. Fever and chills may be more common when both are given together.

• Blood thinners and bleeding disorders can increase the risk of bruising or bleeding at the injection site.

• Inform your healthcare provider about all medicines and vaccines you are receiving before vaccination.

• Observe for about 15 minutes after vaccination for fainting or allergic reactions.

• Keep a record of the vaccine name, batch number, and date of every dose.

• Complete the full vaccination schedule for optimal protection. Infants should receive all programme doses on time.

• Watch for fever that lasts more than 2 to 3 days, swelling that keeps increasing, or an infant who is unusually drowsy or feeding poorly, and contact a doctor.

• Adults should review their pneumococcal vaccination status with their doctor at age 50, at age 65, and when a new long-term health condition develops.

• Seek medical care for cough, fever, fast breathing, or breathlessness even after vaccination, as the vaccine does not protect against all causes of pneumonia.

• 10-valent pneumococcal conjugate vaccine (PCV10).

• 13-valent pneumococcal conjugate vaccine (PCV13).

• 20-valent pneumococcal conjugate vaccine (PCV20).

• 23-valent pneumococcal polysaccharide vaccine (PPSV23).

• 15-valent and 21-valent conjugate vaccines (PCV15, PCV21), used in some other countries.

Pneumococcal vaccines are generally given as standalone preventive vaccines. In infants, they are commonly given during the same visit as other routine vaccines, such as pentavalent, rotavirus, polio, and measles-rubella vaccines, using separate injection sites. In adults, they may be given at the same visit as the flu vaccine or a COVID-19 mRNA vaccine. Vaccines must never be mixed in the same syringe.

• Pneumococcal Vaccines.

• Pneumonia Prevention.

• Preventive Vaccines.

• Childhood Immunisation.

• Adult and Senior Vaccination.

1. Everything you need to know about Pneumonia 

2. Impact of 13 Valent Conjugate Pneumococcal Vaccines In India

3. Is Pneumonia vaccination free for children in India?

1. https://www.who.int/publications/i/item/who-wer10039-411-437

2. https://www.cdc.gov/pneumococcal/vaccines/index.html

3. https://www.fda.gov/vaccines-blood-biologics/vaccines/prevnar-20

4. https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/PCV_Operational_Guidelines.pdf

5. https://pmc.ncbi.nlm.nih.gov/articles/PMC7703813/

The information on this page is for educational purposes only and is not a substitute for medical advice. Please consult your doctor to know if this treatment is appropriate for your condition.