Pneumococcal vaccines – frequently asked questions (FAQs)

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Key points

  • Pneumococcal disease is a group of clinical conditions caused by the bacterium Streptococcus pneumoniae (also called pneumococcus). The most severe form is known as invasive pneumococcal disease (IPD).
     
  • Different types of pneumococci are called serotypes. Over 100 serotypes have been identified, but only a limited number cause disease. Pneumococcal vaccines vary in the number of serotypes they cover. 
     
  • The number in the name of each pneumococcal vaccine represents the number of different serotypes it contains. For example, 13-valent pneumococcal conjugate.
     
  • Pneumococcal vaccination is recommended for infants and children, all people with specified risk conditions, all adults aged 70 years and over and Aboriginal and Torres Strait Islander adults aged 50 years and over.
     
  • Two types of pneumococcal vaccines are currently registered for use in Australia: (i) pneumococcal conjugate vaccines (PCVs); and (ii) a pneumococcal polysaccharide vaccine (PPV). These vaccine types are not interchangeable. They do not contain live bacteria, so they cannot cause pneumococcal disease.
     
  • Pneumococcal vaccine recommendations – such as vaccine type, vaccine brand, number of doses and interval between doses – vary depending on several factors, including the person’s age, immune status and Aboriginal and Torres Strait Islander status; their state or territory of residence; and whether they have previously received doses of a pneumococcal vaccine. 
     
  • For adults aged 18 years and over, two pneumococcal vaccines are funded under the National Immunisation Program (NIP): one PCV (13vPCV) and one PPV (23vPPV). The 23vPPV is only recommended in certain populations following PCV. 
     
  • Other PCVs – 15vPCV and 20vPCV – are registered for use in adults in Australia but not currently funded under the NIP for adults. These are available as privately funded vaccines.
     
  • For children aged under 18 years, 20vPCV is the NIP-funded pneumococcal vaccine following changes to the NIP childhood schedule, which commenced on 1 September 2025. These changes include:
    • 20vPCV replacing 13vPCV as the NIP-funded vaccine for children aged under 18 years
    • expansion of the 4-dose (3+1) PCV schedule to include all Aboriginal and Torres Strait Islander children in all states and territories
    • doses of 23vPPV are no longer required for Aboriginal and Torres Strait Islander children nor children with a risk condition.
       
  • Australia’s pneumococcal vaccination program for adults remains under review.
     

Last updated: 27 August 2025

FAQs

What is pneumococcal disease?

Pneumococcal disease is caused by Streptococcus pneumoniae bacteria (also known as pneumococci). 

These bacteria, which are often found in the nose and throat without causing disease – this is known as asymptomatic nasopharyngeal carriage – can spread to other people through saliva and mucus. 

Pneumococci can spread to other parts of the body, such as the middle ear, blood, brain and lungs, and can cause disease. 

The more severe forms of pneumococcal illnesses – where the bacteria enter body sites that are normally ‘sterile’ – are collectively known as invasive pneumococcal disease (IPD). IPD can be associated with severe long-term consequences and even death.

Who can get pneumococcal disease?

Anyone can develop pneumococcal disease; however, those at greatest risk of disease and severe outcomes are:

  • infants and young children
  • older adults
  • people with certain risk conditions. 

As people age, their immune systems naturally decline, and this increases susceptibility to pneumococcal disease.

Aboriginal and Torres Strait Islander people are also disproportionately impacted by severe pneumococcal disease. 

How common is pneumococcal disease? 

The total number of IPD cases reported in Australia in 2024 was 2,379. The highest proportions of these cases were in infants and children aged less than 5 years (16%) and adults aged over 65 years (34%).

Between 2016 and 2018, the average annual rate of IPD in Australia was 7.8 per 100,000 individuals. During the same period, the reported rate of IPD in infants was 23.9 per 100,000 individuals and in children aged 1–4 years it was 16.3 (n = 618) per 100,000 individuals. The rate of IPD in adults aged 65 years and older was 20.9 per 100,000.

Aboriginal and Torres Strait Islander people are disproportionately impacted by severe pneumococcal disease. Between 2016 and 2018, 11% of the reported IPD cases were in Aboriginal and Torres Strait Islander people; the annual average rate of IPD in this population group was 26.4 per 100,000 individuals.

Pneumococcal-related cases of middle ear infections (otitis media) and lung infections (pneumonia) are several-fold more common than severe disease. 

Pneumococcal disease has a seasonal pattern and is more commonly seen in the winter months. 

More data on IPD cases reported nationally can be found via the National Notifiable Disease Surveillance System.

Which pneumococcal vaccines are available in Australia?

Two types of pneumococcal vaccines are available for use in Australia: (i) pneumococcal conjugate vaccine (PCV); and (ii) a pneumococcal polysaccharide vaccine (PPV). 

These two vaccine types are not interchangeable. 

These vaccines are inactivated, meaning they do not contain live bacteria and cannot cause pneumococcal disease. 

Currently, five pneumococcal vaccines – four PCVs and one PPV – are registered for use in Australia: 

  • 13vPCV (13-valent pneumococcal conjugate vaccine [Prevenar 13]): Registered for use in people aged 6 weeks and over; funded under the National Immunisation Program (NIP) for certain groups of adults aged 18 years and over
  • 15vPCV (15-valent pneumococcal conjugate vaccine [Vaxneuvance]): Registered for use in people aged 6 weeks and over; not NIP-funded
  • 20vPCV (20-valent pneumococcal conjugate vaccine [Prevenar 20]): Registered for use in people aged 6 weeks and over; NIP-funded for children aged under 18 years
  • 21vPCV (21-valent pneumococcal conjugate vaccine [Capvaxive]): Registered for use in people aged 18 years and over; not NIP-funded
  • 23vPPV (23-valent pneumococcal polysaccharide vaccine [Pneumovax 23]): Registered for use in people aged 2 years and over; NIP-funded for certain adults aged 18 years and over.

For more information about each of these vaccines, see the Pneumococcal vaccines available in Australia subsection of the Australian Immunisation Handbook pneumococcal disease chapter. 

How are pneumococcal conjugate vaccines (PCVs) and the pneumococcal polysaccharide vaccine (PPV) different?

Pneumococcal conjugate vaccines (PCVs) and the polysaccharide vaccine (PPV) both contain a polysaccharide (sugar) of the different pneumococcal serotypes (strains). However: 

  • the polysaccharides in PCVs are attached to a ‘helper’ protein (conjugation)
  • the polysaccharides in the PPV are not attached to a ‘helper’ protein. 

Attachment to the helper protein makes the immune response to PCVs stronger and longer lasting than the immune response to PPV. 

Are pneumococcal vaccines interchangeable?

No – PCVs and PPV are not interchangeable.

For infants and children who are recommended multiple doses of PCV, it is recommended to finish a schedule of pneumococcal vaccination with 20vPCV. 

For those recommended to receive PPV, only one vaccine is available (23vPPV).

Who should receive pneumococcal vaccination? 

Pneumococcal vaccination is recommended for:

  • infants and children aged up to 5 years
  • people of all ages with specified medical risk conditions
  • Aboriginal and Torres Strait Islander adults aged 50 years and over
  • non-Aboriginal and Torres Strait Islander adults aged 70 years and over.
Who is eligible to receive a free pneumococcal vaccine under the NIP?

The three pneumococcal vaccines currently funded under the NIP are 13vPCV, 20vPCV and 23vPPV. 

On 1 September 2025, 20vPCV was introduced as the NIP-funded pneumococcal vaccine for:

  • infants and children aged under 5 years
  • Aboriginal and Torres Strait Islander children aged up to 18 years
  • children aged up to 18 years with specified medical risk conditions.

13vPCV is NIP-funded for:

  • Aboriginal and Torres Strait Islander adults aged 50 years and over
  • adults aged 70 years and over
  • adults aged 18 years and over with specified medical risk conditions.

23vPPV is NIP-funded in addition to 13vPCV for: 

How are pneumococcal vaccines administered? 

All PCVs (i.e. 13vPCV, 15vPCV, 20vPCV and 21vPCV) are administered via intramuscular injection. 

The preference is for PPV (23vPPV) to be administered as an intramuscular injection, but it can also be administered subcutaneously. 

For more information see the Vaccines, dosage and administration subsection of the Australian Immunisation Handbook pneumococcal disease chapter

What are the common side effects after receiving pneumococcal vaccines?

Injection site reactions – such as pain, tenderness, redness and swelling – may occur in both children and adults following pneumococcal vaccination. Other general side effects can include muscle aches and pains, fatigue, irritability and chills. 

These symptoms are typically mild and resolve within a few days. 

13vPCV, 15vPCV, 20vPCV, 21vPCV and 23vPPV have similar side effects. Injection-site side effects are more common after the second dose of 23vPPV than after the first dose.  

Is there potential for any rare serious adverse events following pneumococcal vaccination?

There are no concerns regarding the potential for serious adverse events following pneumococcal vaccination.

For more information, see the Adverse events subsection in the of the Australian Immunisation Handbook pneumococcal disease chapter.

Can a person receive other vaccines at the same time as pneumococcal vaccines?

Yes. 

Infants can receive pneumococcal vaccines at the same time as other vaccines given in childhood, including influenza vaccines. 

Adults can receive pneumococcal vaccines at the same time as most other adult vaccines. 

If more than one vaccine is given in the same limb, there should be a minimum 2.5 cm gap between injection sites.

When should infants and children receive their pneumococcal vaccines, and what vaccine should they have?

The number of doses of 20vPCV recommended for infants and children depends on Aboriginal and Torres Strait Islander status and/or whether they have a risk condition.

Aboriginal and Torres Strait Islander children and children with a risk condition(s) for pneumococcal disease, are recommended to receive a 4-dose 20vPCV schedule (known as ‘3+1’ – i.e. 3 initial doses and 1 booster dose). Their schedule is as follows:

  • 1 dose of 20vPCV at 2 months of age
  • 1 dose of 20vPCV at 4 months of age
  • 1 dose of 20vPCV at 6 months of age
  • 1 dose of 20vPCV at 12 months of age.

All other infants are recommended to receive a 3-dose 20vPCV schedule (known as ‘2+1’ – i.e. 2 initial doses and 1 booster dose). Their schedule is as follows:

  • 1 dose of 20vPCV at 2 months of age
  • 1 dose of 20vPCV at 4 months of age
  • 1 dose of 20vPCV at 12 months of age.

Information about state and territory immunisation schedules is available on the NIP schedule.

For more detailed clinical advice, see the Infants and children subsection of the Australian Immunisation Handbook pneumococcal disease chapter.

What are the pneumococcal vaccine recommendations for infants aged under 12 months with risk conditions?

Infants aged under 12 months who are diagnosed with a risk condition are recommended to receive 4 doses of 20vPCV at 2, 4, 6 and 12 months of age. 

What are the pneumococcal vaccine recommendations for children aged 12 months to 18 years with risk conditions?

Children and adolescents are recommended to receive a single dose of 20vPCV at diagnosis. 

Why is 23vPPV no longer recommended for children who receive 20vPCV?

The 23vPPV – which contains 11 additional serotypes than 13vPCV – was previously recommended following 13vPCV for certain groups of children to extend protection against a broader range of pneumococcus serotypes. 

The 20vPCV includes seven of the 11 extra serotypes contained in 23vPPV, and recent IPD data showed that the remaining four serotypes caused very few to no cases in the groups eligible for 23vPPV. 

Therefore, when 20vPCV replaced 13vPCV on the NIP for infants and children, the 23vPPV dose was no longer considered required. 

Are any children still recommended to receive 23vPPV?

No, from 1 September 2025, 23vPPV is no longer required for infants who have received 20vPCV. 

As the childhood schedule transitions to from 13vPCV to 20vPCV, Aboriginal and Torres Strait Islander children living in Northern Territory, Queensland, South Australia and Western Australia and children with a risk condition who completed their childhood PCV schedule with 13vPCV or 15vPCV are recommended to receive a single dose of 20vPCV in place of 23vPPV.

Children who have not received their first dose of 23vPPV are recommended to receive a dose of 20vPCV. They should receive this either at 4 years of age or 12 months after their last dose of PCV, whichever is later. 

Children who have already received their first dose of 23vPPV are recommended to receive a dose of 20vPCV in place of their second dose of 23vPPV. This dose should be given at least five years after the dose of 23vPPV. 

When are adults recommended to receive the pneumococcal vaccine?

A single dose of a PCV (i.e. 13vPCV, 15vPCV or 20vPCV) is recommended for all adults aged 70 years and over. 

For Aboriginal and Torres Strait Islander adults aged 50 years and over and adults with a risk condition aged 18 years and over, the recommended pneumococcal vaccination schedule is as follows:

  • 1 dose of a PCV
  • 1 dose of 23vPPV 12 months later
  • a second dose of 23vPPV at least five years after the first 23vPPV dose.

There is no preference between PCV vaccines (13vPCV, 15vPCV or 20vPCV), although 13vPCV and 23vPPV are NIP-funded.

For more information, see the Adults, Aboriginal and Torres Strait Islander people and People with medical risk factors sections of the Australian Immunisation Handbook pneumococcal disease chapter.

Which catch-up vaccines are recommended if a person has missed a dose of pneumococcal vaccine?

For infants and children who have missed a dose of pneumococcal vaccine, the number of doses and the pneumococcal vaccine required will depend on where the child lives, Aboriginal and Torres Straite Islander status, presence of a risk condition, number of previous pneumococcal vaccine doses received, current age and the age at which the previous dose was administered. 

An immunisation provider can assist with a catch-up schedule; catch-up resources are listed in the Useful links. 

Adults who are recommended a pneumococcal vaccine and have not yet received one should receive a vaccine as soon as possible. The vaccine type and number of doses will be based on the person’s age, Aboriginal and Torres Straite Islander status and whether they have any conditions associated with an increased risk of IPD. 

For more detailed recommendations and catch-up resources, refer to the Pneumococcal disease chapter of the Australian Immunisation Handbook.

What is the recommended interval between doses of the different types of pneumococcal vaccines?

Only adults aged 18 years and over are recommended the two different types of pneumococcal vaccines (i.e. PCVs and PPV). The recommended interval between a dose of any PCV (13vPCV, 15vPCV, 20vPCV) and a dose of 23vPPV is 12 months. However, the order in which the vaccines are given may allow for a shorter interval in certain circumstances – specifically:

  • A 12-month interval is recommended between a dose of PCV and a subsequent dose of 23vPPV; however, an interval of 2–12 months is acceptable. (Note: If a person has already had a dose of 23vPPV prior to their dose of PCV, the second dose of 23vPPV should be given at least five years after the previous dose of 23vPPV or 2–12 months after the dose of PCV – whichever is later.)
  • A minimum interval of five years is recommended between a dose of 23vPPV and a second dose of 23vPPV.
  • A minimum interval of 12 months is recommended between a dose of 23vPPV and any subsequent dose of PCV.
What is the interval between having pneumococcal disease and receiving a pneumococcal vaccine?

Pneumococcal vaccination can occur once a person has recovered from pneumococcal disease.

There is currently no evidence to suggest an instance of pneumococcal disease provides protection from future disease.

There are data that suggest those who have had IPD are at increased risk of pneumococcal disease in future. This is considered a risk condition, and people who have had IPD are recommended to receive additional doses of pneumococcal vaccine. 

Should a person receive a dose of a new higher-valency pneumococcal vaccine if they have previously received another vaccine?

There are currently no recommendations for additional doses of either the 15vPCV or 20vPCV vaccines if a person has already completed an age-appropriate schedule of 13vPCV or 15vPCV. 

Are Aboriginal and Torres Strait Islander children living in New South Wales, Victoria, Tasmania or the ACT who previously completed a 3-dose schedule with a lower valency vaccine recommended a supplementary dose of 20vPCV?

No, children living in New South Wales, Victoria, Tasmania or the ACT who have already completed a 3-dose schedule with 13vPCV or 15vPCV do not require a supplementary dose of 20vPCV. The 4-dose schedule recommendation for Aboriginal and Torres Strait Islander children applies prospectively to children born from 1 March 2025. 

Should children complete their recommended schedule with a dose of a higher-valency pneumococcal conjugate vaccine if they have previously received a lower-valency conjugate vaccine?

Yes, children are recommended to complete their schedule with a 20vPCV if they started it with a lower valency vaccine (13vPCV or 15vPCV). 

How many doses of 23vPPV should a person receive over their lifetime? 

Aboriginal and Torres Strait Islander adults and adults with risk conditions of all ages are recommended to receive 23vPPV. These groups should receive 2 doses five years apart, and no additional doses are required later in life. 

Doses of 23vPPV given during childhood are counted when determining the number of further doses required. There is no current evidence to support the administration of more than 2 doses of 23vPPV, and the risk of adverse reactions is higher with repeat doses. 

For people aged over 18 years who have never received a PCV and are also recommended to receive doses of 23vPPV, the PCV dose should be given first. 

Is there anyone who should not receive pneumococcal vaccines?

The only absolute contraindication for pneumococcal vaccines is anaphylaxis (a severe allergic reaction) after a previous dose of the relevant vaccine or its components.

Should pregnant women receive pneumococcal vaccines?

In most situations, pregnant women who are recommended to receive a pneumococcal vaccine should wait until after the pregnancy to receive the vaccine. However, inadvertent administration during pregnancy is unlikely to result in serious adverse effects. 

Vaccination may be considered for pregnant women who are at high risk of IPD and were not vaccinated before pregnancy. Healthcare providers can give individual advice or seek further guidance from their state or territory specialist immunisation service. 

How effective are pneumococcal vaccines? 

Data on the impact of the introduction of higher-valency pneumococcal vaccines (such as 20vPCV) in Australia are still emerging.

Among children in Australia, receiving 3 doses of 13vPCV was around 90% effective in preventing IPD caused by the serotypes included in the vaccine. Due to the strong ‘herd effect’, the introduction of PCVs has also led to large declines in disease in older age groups.

Pneumococcal vaccination programs have also led to a reduction in hospitalisations due to pneumonia and middle ear infections. 

The impact of these programs has, however, been lower among Aboriginal and Torres Strait Islander people and people with underlying medical conditions that increase their susceptibility to pneumococcal disease.

If the 23vPPV vaccine protects against more strains than 13vPCV, why do we still need to give 13vPCV to adults who are eligible to receive 23vPPV?

The conjugate and polysaccharide vaccines protect against pneumococcal disease in different ways. People at higher risk of pneumococcal disease are likely to benefit from both types of protection.

Why are pneumococcal vaccines NIP-funded for certain groups but not for others? 

The risk of pneumococcal disease varies widely among people based on a range of factors, including age and underlying medical conditions. 

The Pharmaceutical Benefits Advisory Committee provides advice and recommendations to the Australian Government Department of Health, Disability and Ageing to inform these decisions. For more information, see National Immunisation Program (NIP) vaccine listing process.

What is the scientific evidence behind the Australian Technical Advisory Group on Immunisation (ATAGI) recommendations for pneumococcal vaccines? 

Current ATAGI recommendations for pneumococcal vaccination – which are included in the Australian Immunisation Handbook – were made following thorough review of evidence, including Australian data, by immunisation experts.

NCIRS supported this work through use of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The GRADE assessments for pneumococcal vaccines are available here. 

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