Pneumococcal vaccines – frequently asked questions (FAQs)

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NCIRS fact sheets, FAQs and other resources

  • 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, 20-valent pneumococcal conjugate vaccine (20vPCV) contains 20 serotypes. 
     
  • Two pneumococcal conjugate vaccines (PCVs) are funded under the National Immunisation Program (NIP) for use in Australia: 20vPCV for children (aged <18 years) and 21vPCV for adults. 
     
  • The following changes to the NIP childhood schedule commenced on 1 September 2025:
    • 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 (previously only given to Aboriginal and Torres Strait Islander children in the Northern Territory, Queensland, South Australia and Western Australia)
    • doses of 23-valent pneumococcal polysaccharide vaccine (23vPPV) are no longer required for Aboriginal and Torres Strait Islander children nor children with a risk condition.
       
  • The following changes to the adult schedule will commence on 1 July 2026:
    • 21vPCV will replace 13vPCV as the NIP-funded vaccine for adults aged 18 years and over 
    • the recommended age for adults without a risk condition will be lowered to 65 years from 70 year
    • the recommended age for Aboriginal and Torres Strait Islander adults without a risk condition will be lowered to 25 years from 50 years
    • Aboriginal and Torres Strait Islander adults and all adults with a risk condition will no longer require doses of 23vPPV
    • all adults will be recommended to receive a dose of 21vPCV after their last pneumococcal vaccine – regardless of previous pneumococcal vaccine history. 
       
  • 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. 15vPCV is also registered and available as a privately funded vaccine for children. 

These FAQs have been updated to align with the new adult pneumococcal program that will commence on 1 July 2026. To review the current adult vaccination recommendations please refer to the pneumococcal chapter in Australian Immunisation Handbook. 

Last updated: 4 June 2026

FAQs

General

Infants, children and adolescents

Adults (aged 18 years and over)

Useful links

 

General

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 in children without causing disease – this is known as asymptomatic nasopharyngeal carriage – can spread to other people through saliva and mucus. 

Pneumococci, once infected, can spread to other parts of the body, such as the middle ear, blood, brain and lungs, to 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 lead to severe long-term consequences and even death.

Viral respiratory illnesses can predispose to IPD as a secondary infection.

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 pneumococcal disease.

How common is pneumococcal disease? 

In 2024, about 2,400 IPD cases were reported in Australia, of which about 16% were in young children aged less than 5 years and 34% in adults aged over 65 years.

Between 2023 and 2024, the average annual rate of IPD in Australia was 8.6 per 100,000 individuals. During the same period, the reported rate per 100,000 individuals was: 

  • 33.6 in infants aged less than 2 years 
  • 18.2 in children aged 2–4 years 
  • 18.4 individuals in adults aged 70 years and older.

Aboriginal and Torres Strait Islander people experience a high burden of 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 IPD.  

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?

Three pneumococcal conjugate vaccines (PCVs) are registered for use in Australia: 

  • 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; NIP-funded for adults aged over 18 years. 

These vaccines are made using only small parts of the bacteria which are inactivate, meaning they do not contain live bacteria and cannot cause pneumococcal disease.

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

Why is 23-valent pneumococcal polysaccharide vaccine (23vPPV) no longer recommended for children and adults?

The 23vPPV was previously recommended after 13vPCV to extend protection against additional pneumococcal serotypes. However, the 20vPCV used in children and 21vPCV used in adults now cover most of the serotypes responsible for IPD. 

Surveillance data show that the remaining serotypes in 23vPPV cause illness in very few cases in the relevant populations. As a result, the extra benefit of 23vPPV is considered minimal when 20vPCV or 21vPCV is used, and it is no longer routinely used in Australian populations.

Are pneumococcal vaccines interchangeable?

Pneumococcal vaccines are only interchangeable for infants and children who are recommended multiple doses of PCV. However, 20vPCV is the only NIP-funded pneumococcal vaccine for infants and children and it is recommended to finish a schedule of pneumococcal vaccination with 20vPCV, even if started with a different PCV. 

21vPCV is not registered for use in children. 

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-Indigenous adults aged 70 years and over.
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. Individuals who are recommended to receive pneumococcal vaccination can receive it at the same time as other age-appropriate vaccines.

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

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 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.

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.

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.

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. 

 

Infants, children and adolescents

When are infants and children recommended to 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 all 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 primary 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 primary 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.

Which infants, children and adolescents are eligible to receive a free pneumococcal vaccine under the NIP? 

20vPCV is the only NIP-funded pneumococcal vaccine for infants, children and adolescents. It is funded 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.
What is recommended for children who have not received 20vPCV and previously were recommended 2 doses of 23vPPV?

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. Their schedule is then complete, and no further doses are required.

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. 

See Pneumococcal vaccination recommendations for people who have previously received a pneumococcal vaccine.

Do Aboriginal and Torres Strait Islander children and children with risk conditions still require an additional dose of 20vPCV if they have received at least 1 dose of the vaccine as part of their routine schedule?

No, Aboriginal and Torres Strait Islander children and children with a risk condition who started their course with 13vPCV or 15vPCV but received at least 1 dose of 20vPCV as part of their routine schedule do not require an additional dose of 20vPCV. For example, if a child received 13vPCv for their 2-, 4- and 6-month dose and received 20vPCV as their 12-month dose, no further doses are needed.

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.

If a child does receive a fourth dose, there are no safety concerns and no action is required. 

Are non-Indigenous children without a risk condition who completed their 3-dose schedule with a lower valency vaccine recommended a supplementary dose of 20vPCV?

No, non-Indigenous children without a risk condition who have completed the 3-dose schedule with 13vPCV or 15vPCV do not require a supplementary dose of 20vPCV. This is because most of these children will be entering an age where the risk for severe disease is lower and the incremental benefit from the additional serotypes in 20vPCV is likely to be low.

If a child does receive a fourth dose, there are no safety concerns and no action is required. 

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 using 20vPCV for the remaining dose (or doses) if they started it with a lower valency vaccine (13vPCV or 15vPCV). 

What is the recommendation if 13vPCV or 21vPCV is given to a child instead of 20vPCV?

If a child is accidentally given 13vPCV or 21vPCV instead of 20vPCV, they should receive a dose of 20vPCV. When they should receive this will depend on where they are in their schedule:

  • If a child receives 13vPCV and still requires doses to complete the 2+1 or 3+1 schedule, they should receive 20vPCV at their next scheduled dose.
  • If a child receives 13vPCV as their 12-month dose, a dose of 20vPCV should be given two months later.
What is the recommendation if 23vPPV is given to a child instead of 20vPCV?

If a child who was previously recommended 23vPPV is accidentally given 23vPPV instead of 20vPCV, then a dose of 20vPCV should be given at least 12months after the 23vPPV dose.

Which catch-up vaccines are recommended for infants, children and adolescents who have missed a dose of pneumococcal vaccine?

For infants and children who have missed a dose (or doses) of pneumococcal vaccine, catching up is required using 20vPCV. The number of doses required will depend on where the child lives, Aboriginal and Torres Strait 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’. 

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

 

Adults (aged 18 years and over)

What are the pneumococcal vaccine recommendations for adults?

From 1 July 2026, a single dose of a 21vPCV is recommended for all adults aged 65 years and over, Aboriginal and Torres Strait Islander adults aged 25 years and over and adults aged 18 years and over with a risk condition.

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 adults are eligible to receive a free pneumococcal vaccine under the NIP?

From 1 July 2026, 21vPCV is funded under the NIP for:

  • adults aged 65 years and over
  • Aboriginal and Torres Strait Islander adults aged 25 years and over
  • adults aged 18 years and over with specified medical risk conditions.
Which catch-up vaccines are recommended for adult who have missed a dose of pneumococcal vaccine?

Adults who are recommended to receive 21vPCV and have not yet done so should receive a vaccine as soon as possible. 

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

Should adults receive a dose of 21vPCV if they have previously received another pneumococcal vaccine?

Yes, all adults who have previously received a dose of any pneumococcal vaccine –including 23vPPV (a pneumococcal polysaccharide vaccine), 13vPCV, 15vPCV or 20vPCV – are recommended to receive a dose of 21vPCV at least 12 months after their last dose. This dose is NIP-funded regardless of when their previous pneumococcal vaccine was received. 

This includes adults who were diagnosed with a risk condition before the age of 18 years and received a childhood scheduled dose of 20vPCV or 13vPCV+23vPPV.

What should be done if a pneumococcal vaccine other than 21vPCV is given to an adult?

If an adult who was previously recommended 23vPPV is accidentally given 23vPPV instead of 21vPCV, then a dose of 21vPCV should be given at least 12months after the 23vPPV dose.

If an adult is accidentally given 13vPCV, 15vPCV or 20vPCV instead of 21vPCV, they should receive a dose of 21vPCV at least 2 months later. 

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. 

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