Updated September 2015

Vaccines: Pneumococcal Polysaccharide Vaccine (Pneu-P-23) and Pneumococcal Conjugate Vaccine (Pneu-C-13)

What Is Pneumococcal Disease?

It is a disease caused by bacteria called Streptococcus pneumoniae. It can cause serious infections in the blood, lining of the brain and spinal cord (meningitis), lungs (pneumonia), and ear infections in children.

Who Can Get This Disease?

Anyone can get it but some groups of people are at higher risk including those with chronic medical conditions (liver, heart, lung or kidney disease, diabetes), weak immune systems (cancer, HIV infection), those without a spleen, smokers, alcoholics, the very young and those older than 65 years. In the past, outbreaks occurred among people who were homeless, crack cocaine users and injection drug users.

How Is It Spread?

It can be spread by coming in contact with spit (saliva) or nose droplets from infected people. This can happen by sharing things like cigarettes, eating utensils or crack pipes, kissing or when an infected person coughs or sneezes on you.

How Is It Treated?

Pneumococcal infections can be treated with antibiotics. Even with the right treatment, some people can get very sick and in rare cases can die.

How Can I Protect Myself Against Pneumococcal Disease?

If you are at high risk, get vaccinated with the pneumococcal polysaccharide vaccine (Pneu-P-23) and the pneumococcal conjugate vaccine (Pneu-C-13). Do not share things like cigarettes, crack pipes, knives, forks or cups; cover your mouth when you sneeze or cough; and wash your hands often.

What Are the Side Effects of the Pneumococcal Vaccine?

Reactions to this vaccine are usually mild and include soreness or redness at the site where the needle was given or a slight fever. The redness and swelling where the vaccine was given can be more noticeable if the same vaccine is given within four years. Severe reactions such as difficulty breathing and rash are very rare. If you have a serious reaction after getting the vaccine, see a doctor immediately.

Who Should Get the Pneumococcal Polysaccharide Vaccine (Pneu-P-23)?

The vaccine is available free of charge in Ontario for the following groups:

  • Adults 65 years or older
  • All residents of nursing homes, homes for aged, chronic care facilities or wards
  • All homeless and under-housed individuals
  • Those with a chronic medical condition (e.g. liver, heart, lung or kidney disease; diabetes)
  • Those with a weak immune system (e.g. cancer, HIV infection, due to medications)
  • Those without a spleen
  • Cochlear implant recipients                                                                             
  • All children under 2 years of age get protected against pneumococcal disease with a different vaccine (pneumococcal conjugate vaccine) as part of the routine childhood schedule

How Many Doses of the Vaccine Do I Need?

Most people need one shot but individuals at high risk for severe pneumococcal disease who received their first shot when they were 11 years of age or older can get a second shot in 5 years. Children who received their first shot of Pneu-P-23 when they were 10 years of age or less can get the second shot in 3 years.

Who Should Not Get the Pneumococcal Polysaccharide Vaccine (Pneu-P-23)?

Pneu-P-23 vaccine should not be given to individuals who:

  • Have received a pneumococcal conjugate vaccine in the last 8 weeks (eg. Prevnar 13)
  • Have had a serious allergy to the pneumococcal vaccine in the past
  • Have a serious allergy to phenol, sodium chloride, disodium phosphate, monosodium phosphate
  • Were diagnosed with Guillain-Barré Syndrome within 8 weeks of receiving a previous dose of Pneu-P-23

Is This Vaccine Safe to Give to Pregnant Women?

Pneu-P-23 is thought to be generally safe for pregnant women. It is recommended that pregnant women at high risk for severe pneumococcal disease should get this vaccine.

Who Should Get the Pneumococcal Conjugate Vaccine (Pneu-C-13)?

A single dose of the vaccine is available free of charge in Ontario for individuals aged 50 years of age and older with the following high risk conditions (with an exception of hematopoietic stem cell transplant recipients noted below):

  • Hematopoietic stem cell transplants (HSCT)*
  • HIV infection
  • Immunosuppressive conditions, specifically:
    • Asplenia (anatomical or functional);
    • Sickle cell disease or other hemoglobinopathies;
    • Congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdine, or factor D deficiencies), or phagocytic functions;
    • Immunosuppressive therapy including use of long term corticosteroids, chemotherapy, radiation therapy, post-organ-transplant therapy, biologic and non-biologic immunosuppressive therapies for rheumatologic and other inflammatory diseases;
    • Malignant neoplasms including leukemia and lymphoma; or
    • Solid organ or islet cell transplant (candidate or recipient)


*HSCT recipients should receive 3 doses of Pneu-C-13 starting at 3 to 9 months after transplant. These doses should be at least 4 weeks apart.

For all other adults one dose of Pneu-P-23 vaccine should be administered 8 weeks after the dose of Pneu-C-13 OR one dose of Pneu-C-13 should be administered at least one year following any previous dose of Pneu-P-23.

Where Can I Get More Information?

Talk to your doctor or call the Toronto Public Health Immunization Information Line at 416-392-1250.