Pneumonia Vaccination
About
(Please note: Initially, I wrote this information with links to CDC information about these vaccines, diseases and surveillance in the United States. However, on February 8th, 2025, the CDC ceased to post new surveillance updates due to the recent directives of the Trump administration. Therefore, the general information should still be applicable but links may be broken and/or outdated).
PNEUMONIA (PNEUMOCOCCAL) VACCINATIONS
The formulations of pneumococcal vaccines and protocols for giving those change pretty frequently. Recommendations also sometimes change based on a patient's medical circumstances.
If you are unsure which pneumococcal vaccination you have had or which one you need, check with a healthcare provider or the CDC vaccine website for the latest protocols.
Pneumococcal vaccination is highly recommended for adults, especially for people over 65 and those with various health conditions, such as heart problems, lung problems, smoking, diabetes, and others (see risk factors). This vaccination can help prevent pneumonia and other secondary infections caused by pneumococcus, such as sinusitis, ear infections, meningitis, etc.
Choosing a vaccine can be confusing because there are four primary pneumonia vaccines, and many people do not know which ones they have had or have not had. Included are PCV 13 (rarely given to adults), PCV15, PCV20, PCV21, PPSV 23. The numbers on each determine how many strains each cover - they are very different in coverage.
DOSAGE/TYPE
"Which one should I get?" Here are some recommendations:
If you do not know if you have had a pneumonia vaccination or have had one but do not remember which, 1) Check with your healthcare provider. 2) Check if your state records have residents' vaccinations 3) Get a blood test to check for immunity.
Vaccine "rules":
If you have never had a pneumococcal vaccine or do not know, get a PCV 20 or 21 - that may be enough.
or at least one year later, the PPSV 23 (may not be necessary_
or get a PCV 15 followed by a 23
If you have only one PCV 13, you should get a PPSV 23 or PCV 20
If you have only one PPSV 23, your healthcare provider may recommend that you get a dose of PCV 15 or 20 after at least one year.
If you have only had PCV 15, you should get a dose of PPSV 23 after at least one year.
If you get a PCV23 before 65 years old your healthcare provider may recommend another dose after 65 years.
A series of two pneumonia vaccines, 13+23, 23 and 23, 13 and 20, 15 and 23, or 20 or 21 alone, should provide lifetime resistance.
Note: As noted on the CDC's pneumococcal website, some dose and sequence exceptions exist for people with particular underlying conditions.
The pneumonia vaccine is usually well tolerated but often causes soreness at the site. Sometimes, it causes more severe side effects, like body aches or a fever. If you have had a severe reaction to another vaccine(s), or if you have an immune disorder, discuss use with your primary care provider before getting the vaccine. But you may be able to avoid getting another potentially severe illness like pneumonia, so consider getting this vaccination: "...vaccinations for influenza and S. pneumoniae have significantly lowered the rates of sickness and death in older people compared with no vaccination."
Q&A
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I pass out when I get shots. Should I avoid getting them?
Passing out when you get a shot is not that uncommon. First, discuss this with a healthcare provider. Most of these reactions are vasovagal reactions. Most of the time, your mind is just fine about it, but your body does not like it one bit. Once you decide to get the vaccine, be sure to hydrate before and tell the person giving you the vaccine that you sometimes pass out when you get it. The person giving you the vaccine will accommodate your problem by laying you down before you get the vaccination. They will give you the shot and keep an eye on you afterward. ​
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I am immune compromised. Should I get vaccinated?
Those with immunocompromising conditions or on medications that cause potential immune compromise should talk to an immunologist before getting a live virus vaccination because they may not be able to fight off the potential disease that the live virus can cause.
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Does Insurance cover vaccinations?
Although insurance is supposed to cover preventive services, it sometimes does not. Call your insurance company to see if they cover the ones you want and ask where they are covered. Some are only covered in medical facilities like doctors' offices or clinics, and others are only covered at pharmacies (i.e., shingles). They are the COVID-19, flu, pneumococcal, and hepatitis B vaccines.
Traditional Medicare is especially tricky: As of this writing, it only covers Hepatitis B for beneficiaries who are at medium or high risk for the virus and Tdap for those with a documented injury.
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The other four vaccines—shingles, RSV, Tdap, and hepatitis A—are covered by Medicare Part D, the optional prescription drug program available to people with Traditional Medicare or Medicare Advantage plans. Again, be sure to ask your insurance company if they are covered and where. If you do not do this correctly, you can end up with a hefty vaccination bill.
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I have heard that I should NOT take Tylenol or Ibuprofen (Advil, Motrin) after a vaccination - that it will dull my immune response. Is this correct?
Most sources agree that it is acceptable for adults to take ibuprofen or Tylenol (acetaminophen) after a vaccination for side effects: Those medicines will not cause a problem with immune response. That being said, if your side effects are not too bad and you do not need to take those medications, you feel you can weather through the side effects, try to do that. Use a cool cloth at the site for soreness, move the arm you got the injection a lot, and dress in cool clothing if you feel hot. Still, if you need the medications for side effects, take them.
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​For more information about vaccines see the CDC
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*Disclaimer: The material above is for informational purposes only. This information is not intended to diagnose, treat, or cure a condition. The uses listed above are tentative; some have or are undergoing research trials, but many are not FDA-approved. You must investigate these supplements further before deciding to use them. Check interactions and contraindications on sites like Drugs.com or WebMD. Do not attempt to treat a serious condition like liver, kidney problems, high blood pressure, heart, cancer, diabetes, or thyroid issues without discussing it with a healthcare provider first. If you are pregnant, do not use supplements without discussing it with your healthcare provider.