Disease & Vaccine Information

Pneumococcal disease and vaccine quick facts

Updated June 08, 2024

Pneumococcal (S. Pneumoniae) 

Image source: CDC PHIL
  • Pneumococcal disease is a bacterial infection caused by S. pneumoniae (Streptococcus pneumoniae). It is the most common cause of bacterial pneumonia and middle ear infection (otitis media) in the U.S., and is the third most frequent cause of bacterial meningitis.  Pneumococcal bacteria are often found in the upper area of the throat behind the nose in about 5 to 90 percent of healthy individuals.  However, when pneumococcal bacteria cause invasive infection, serious complications can lead to inflammation of the brain, blood infections, pneumonia and death. 
  • Symptoms of pneumococcal infection include sudden onset of fever and fatigue, sneezing and cough with mucous and shortness of breath. The infection may start with a general feeling of being unwell, a low-grade fever and a cough that doesn’t include mucous before symptoms worsen. Symptoms of pneumococcal meningitis (brain inflammation) include stiff neck (inability to touch the chin to chest without moderate to severe pain in the back of the neck and head); headache; extreme fatigue or seizures. Symptoms of otitis media include a painful ear, red or swollen eardrum, fever, and irritability.  
  • Pneumococcal bacteria are primarily transmitted through respiratory secretions by coughing and sneezing.  Persons most at risk of developing invasive pneumococcal disease include immunocompromised individuals, smokers, persons with chronic cardiac, lung, or kidney disease, individuals without a spleen, and persons with cochlear implants or a cerebrospinal fluid leak. Children attending daycare along with African Americans, Alaskan Natives, and certain American Indian Natives may also be at an increased risk of disease. 
  • Otitis media, often referred to as a middle ear infection, is commonly caused by S. pneumoniae and remains the most common pediatric infection requiring treatment by the age of 12 months. Over 60 percent of children will experience at least one episode of acute otitis media prior to the age of one. S. pneumoniae is the leading cause of bacterial meningitis in children under the age of five. Pneumococcal pneumonia, the most common infection caused by S. pneumoniae in adults, is estimated to cause over 150,000 hospitalizations each year in the United States. Between 10 and 30 percent of all community acquired pneumonias are caused by S. pneumoniae.  
  • Globally, 14 percent of deaths worldwide in children under five are related to pneumonia, with most deaths occurring in sub-Saharan Africa and south Asia.  In the United States, the CDC combines the death rates of pneumonia with influenza and estimates it to be the eighth leading cause of deaths in persons 65 years of age or older.  In 2020, there were 11,718 confirmed cases of invasive S. pneumoniae in the U.S., with 536 cases occurring in children under the age of five. 

Pneumococcal Vaccine

  • There are four pneumococcal vaccines licensed by the U.S. Food and Drug Administration (FDA) for use in the U.S. today. Pneumovax 23 is a pneumococcal polysaccharide vaccine (PPSV23) manufactured by Merck and contains 23 strains of pneumococcal and is approved for use in adults 50 and older and in children two and older who are at an increased risk for pneumococcal disease.  Prevnar 13 (PCV13) , Prevnar 20 (PCV20)  and VAXNEUVANCE (PCV15)  are pneumococcal conjugate vaccines and approved for use in individuals six weeks of age and older for the prevention of invasive pneumococcal disease.
  • The CDC recommends four doses of pneumococcal conjugate vaccine (PCV13, PCV15 or PCV20) for all infants and children, with a dose given at 2, 4, 6 and between 12 and 18 months of age. Individuals older than two who are immunocompromised or have medical conditions that are believed to place them at an increased risk for invasive pneumococcal disease are also recommended to receive additional doses of pneumococcal vaccines. The CDC also recommends that all adults 65 years of age and older receive pneumococcal vaccines. 
  • According to the CDC, PCV7, the original pneumococcal conjugate vaccine, resulted in a 97 percent decrease in invasive pneumococcal disease caused by the seven pneumococcal strains found within the vaccine.  However, the mass use of PCV7 vaccine by American children put pressure on some of the nearly 90 additional pneumococcal strains known to cause invasive disease resulting in an increased rate of otitis media caused by strains not included in the seven-valent vaccine.    In an attempt to prevent six additional pneumococcal strains from causing invasive disease, PCV13 vaccine was developed to replace PCV7.  Current research indicates that while PCV13 has significantly decreased nasopharyngeal colonization with the strains found in the vaccine, replacement with non-vaccine type strains continues.     PCV15 and PCV20 were developed to target additional pneumococcal strains not covered by PCV13, however, there is no clinical data to determine whether these particular vaccines will prevent invasive pneumococcal disease caused by the additional strains targeted by these vaccines.   
  • Reported pneumococcal vaccine reactions include fever, severe local reactions (swelling, redness, and pain at site of injection), irritability, drowsiness, restless sleep, vomiting, diarrhea, rash, decreased appetite, convulsions, asthma, pneumonia, lymphadenopathy (swelling of the lymph nodes), cyanosis (inadequate oxygenation of the blood) in children, anaphylaxis and shock, apnea in infants, and sudden infant death syndrome (SIDS).       
  • Using the MedAlerts search engine, as of May 31, 2024, there have been 27,612 serious adverse events reported to the Vaccine Adverse Events Reporting System (VAERS) in connection with pneumococcal vaccinations (PCV7, PCV13, PCV15, PCV20, PPSV23). Over 57 percent of these reported serious pneumococcal vaccine-related adverse events occurred in children under six years of age. Of these pneumococcal-vaccine related adverse event reports to VAERS, 2,757 were deaths, with nearly 66 percent occurring in children under 6 years of age.
  • As of June 1, 2024, there have been 390 claims filed in the federal Vaccine Injury Compensation Program (VICP) for injuries and deaths following vaccination with pneumococcal conjugate vaccine (PCV), including 26 deaths and 364 serious injuries. Pneumococcal polysaccharide vaccine (PPSV23) is not covered under the federal Vaccine Injury Compensation Program (VICP) and compensation for injuries and deaths related to vaccination with PPSV23 are pursued in civil court. 

Food & Drug Administration (FDA) 

Centers for Disease Control (CDC)

Vaccine Reaction Symptoms & Ingredients

Our Ask 8, If You Vaccinate webpage contains vaccine reaction symptoms and more. 

Search for Vaccine Reactions

NVIC hosts MedAlerts, a powerful VAERS database search engine. MedAlerts examines symptoms, reactions, vaccines, dates, places, and more.

Reporting a Vaccine Reaction

Since 1982 the NVIC has operated a Vaccine Reaction Registry, which has served as a watchdog on VAERS. Reporting vaccine reactions to VAERS is the law. If your doctor will not report a reaction, you have the right to report a suspected vaccine reaction to VAERS. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about Pneumococcal and the Pneumococcal vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

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