At what age can pneumococcal (Streptococcus pneumoniae) vaccines be given?

Pneumococcal Vaccine Administration Age Guidelines

Pneumococcal conjugate vaccine (PCV) should be administered to all infants beginning at 6 weeks of age, with routine vaccination recommended at 2,4,6, and 12-15 months of age. 1

Recommended Vaccination Schedule for Infants and Young Children

• The primary pneumococcal vaccination series consists of doses at 2,4,6, and 12-15 months of age 1
• The minimum age for the first dose of pneumococcal conjugate vaccine is 6 weeks 1, 2
• For children beginning vaccination at an older age, a reduced number of doses is recommended based on the age at first vaccination 3

Specific Recommendations by Age Group

Birth to 23 months:

• All infants should receive the complete pneumococcal conjugate vaccine series 1, 3
• The vaccination schedule includes doses at:
  • 2 months of age (can be given as early as 6 weeks) 1, 2
  • 4 months of age
  • 6 months of age
  • 12-15 months of age (booster dose)

24-59 months (2-5 years):

• Children with high-risk conditions who have not been previously vaccinated should receive two doses of PCV 3
• High-risk conditions include:
  • Sickle cell disease
  • Asplenia (functional or anatomic)
  • HIV infection
  • Immunocompromising conditions
  • Chronic illness
  • Cochlear implants
  • Cerebrospinal fluid leaks 1

Vaccine Types and Considerations

• Several pneumococcal vaccine formulations are available:

  • 7-valent pneumococcal conjugate vaccine (PCV7) - historical, no longer manufactured 1
  • 13-valent pneumococcal conjugate vaccine (PCV13) 1
  • 15-valent pneumococcal conjugate vaccine (PCV15) 1
  • 20-valent pneumococcal conjugate vaccine (PCV20) 1
  • 23-valent pneumococcal polysaccharide vaccine (PPSV23) - not effective in children under 2 years 1

• Pneumococcal conjugate vaccines are specifically designed for young children, as the polysaccharide vaccine (PPSV23) does not produce adequate immune responses in children under 2 years of age 1, 2

Common Pitfalls and Considerations

• Waiting too long to initiate pneumococcal vaccination increases risk, as the highest rates of invasive pneumococcal disease occur in children under 2 years, with peak incidence of pneumococcal meningitis around 5 months of age 1, 4

• Failure to complete the full vaccination series leaves children vulnerable to pneumococcal disease 5

• Children with high-risk conditions who have received PCV should also receive PPSV23 after age 2 years for expanded serotype coverage 1

• For children with sickle cell disease, a complete PCV series is essential, with catch-up dosing through 71 months of age if needed 1

• The pneumococcal conjugate vaccine has demonstrated 94-100% efficacy against invasive pneumococcal disease for included serotypes 6