Pneumococcal Vaccines Information for Health Professionals

January 2020

Pneumococcal disease is common in young children, but older adults are at greater risk for complications and death. There are two types of vaccines to protect against pneumococcal disease.

  • Pneumococcal Conjugate Vaccine (PCV13 or Prevnar®13)
  • Pneumococcal Polysaccharide Vaccine‎ (PPSV23 or Pneumovax®23)

For more information, refer to the Canadian National Advisory Committee of Immunization (NACI) and Ontario’s Publicly Funded Immunization Schedule.

Timing and Spacing for Publicly Funded Pneumococcal Vaccines

Routine schedule

Client group Age Dose(s) Vaccine Type
healthy infant series two, four and 12 months three-dose series PCV13
older adults 65 years and older one dose PCV13 and PPSV23

Childhood catch up series

Client group Age Dose(s) Vaccine Type
healthy toddlers 12 to 23 months two doses, two months apart PCV13
healthy children two to five years one dose PCV13

Prevnar®13 is not recommended after six years of age if a child never received it

The biggest risk for invasive pneumococcal disease occurs in healthy children less than six years of age. NACI does not recommend routine vaccination after this age. Older children benefit more from herd protection from younger children.

Prevnar®13 and Pneumovax® in adults

In Ontario:

  • PPSV23 (Pneumovax®23) is publicly funded (free) for adults ages 65+*.
  • PCV13 (Prevnar®13) may be purchased on an individual basis for seniors 65+*.
  • PCV13 is free for adults at high risk of pneumococcal disease. See table below‡.

*Schedule

  • Give PCV13 first, then PCV-23, eight weeks later.
  • If PPSV23 was given first, then wait one year before giving PCV-13.

‡Publicly funded pneumococcal vaccine for high-risk Individuals

High-Risk Clients Dosage Vaccine Type Indications
ages two, four, six, 12 months total of four doses PCV13 See below #1 to 14
age two to 64 years one dose PPSV23 See below #1 to 17
ages two years and older one dose (as second dose) PPSV23
  • asplenia (functional or anatomic) or sickle cell disease
  • hepatic cirrhosis
  • HIV Immunocompromised related to disease or therapy
  • renal failure (chronic) or nephrotic syndrome
ages 50 years and older one dose PCV13
  • asplenia (anatomical or functional)
  • congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin or factor D deficiencies), or phagocytic functions
  • HIV
  • immunocompromising therapy including use of long-term corticosteroids, chemotherapy, radiation therapy, post-organ-transplant therapy, biologic and certain anti-rheumatic drugs
  • malignant neoplasms including leukemia and lymphoma
  • sickle cell disease or other hemoglobinopathies
  • solid organ or islet cell transplant (candidate or recipient)
ages 50 years and older three doses PCV13 Hematopoietic Stem Cell Transplantation (HSCT) recipient

Indications for PSSV23

  1. asplenia (functional or anatomic), splenic dysfunction
  2. cardiac disease (chronic)
  3. cerebral spinal fluid leak (chronic)
  4. cochlear implant recipients (pre/post implant)
  5. congenital (primary) immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin or factor D deficiencies), or phagocytic functions
  6. Diabetes mellitus
  7. HIV
  8. immunocompromising therapy including use of long-term systemic corticosteroid, chemotherapy, radiation   therapy,  post-organ transplant therapy, certain anti-rheumatic drugs and other immunosuppressive therapy
  9. liver disease (chronic), including hepatitis B and C, and hepatic cirrhosis due to any cause
  10. malignant neoplasms, including leukemia and lymphoma
  11. renal disease (chronic), including nephrotic syndrome
  12. respiratory disease (chronic), excluding asthma, except those treated with high-dose corticosteroid therapy
  13. sickle-cell disease and other sickle cell haemoglobinopathies
  14. solid organ or islet cell transplant (candidate or recipient)
  15. neurologic conditions (chronic) that may impair clearance of oral secretions
  16. HSCT (candidate or recipient)
  17. residents of nursing homes, homes for the aged and chronic care facilities or wards