Pneumococcal Vaccination Booster Timing in Children
For healthy children who complete the primary PCV13 series (doses at 2,4, and 6 months), the booster dose must be given at 12-15 months of age, at least 8 weeks after the third dose. 1
Standard Vaccination Schedule by Age
Infants Starting at 2-6 Months
- Primary series: 3 doses at 2,4, and 6 months with minimum 4-week intervals between doses 1
- Booster dose: Single dose at 12-15 months, at least 8 weeks after the third primary dose 1, 2
- This completes the standard 4-dose series for healthy children 1
Catch-Up Schedules for Late Starters
Children 7-11 months at first dose:
- Give 2 primary doses with at least 4-week intervals 1
- Booster dose at 12-15 months, at least 8 weeks after the second dose 1, 2
Children 12-23 months at first dose:
- Give 2 doses total, spaced at least 8 weeks apart 1
- No separate booster is needed—the second dose serves as the final dose 1
Healthy children 24-59 months:
- Give only 1 dose if previously unvaccinated or incompletely vaccinated 1
- No booster needed at this age for healthy children 1, 2
Special Populations Requiring Additional Doses
Children 24-71 months with high-risk conditions (immunocompromising conditions, functional/anatomic asplenia, sickle cell disease, HIV infection, cochlear implants, or CSF leaks):
- Give 2 doses spaced 8 weeks apart if they received fewer than 3 doses before age 24 months 1, 2
- If they completed a 4-dose series, give 1 supplemental dose at least 8 weeks after the most recent dose 1, 2
Children 6-18 years with high-risk conditions:
- Give a single dose of PCV13 if not previously received, regardless of prior PCV7 or PPSV23 vaccination 1, 2
Critical Timing Rules
- Minimum interval for children ≥12 months: 8 weeks between any PCV13 doses 1, 2
- Minimum interval for infants <12 months: 4 weeks between primary series doses 1, 2
- Earliest first dose: Can be given as early as 6 weeks of age 1
Long-Term Protection
Healthy children do not need repeat vaccination after completing the age-appropriate series. 3 The standard 4-dose PCV13 series provides durable protection throughout childhood without additional booster doses beyond the toddler dose at 12-15 months. 3 No routine pneumococcal conjugate vaccine doses are recommended for healthy children after age 5 years. 3
Common Pitfalls to Avoid
- Missing the supplemental dose: Children aged 14-59 months who completed PCV7 series need one supplemental PCV13 dose at least 8 weeks after their last PCV7 dose 1, 4
- Inadequate intervals: Always ensure at least 8 weeks between doses for children ≥12 months; giving doses too close together reduces immunogenicity 1
- Overlooking high-risk children: Children with underlying medical conditions require additional doses through age 71 months, not just through age 59 months like healthy children 1, 2