FAQ: How a Variety of Pneumococcal Vaccines Protect Patient Populations

Pharmacists have the clinical expertise to navigate the rapidly evolving landscape of pneumococcal immunization, from distinguishing between multiple vaccine technologies to identifying specific patient risk factors and local serotype prevalence.

Staying current with the latest schedules from organizations like the CDC and the American Academy of Family Physicians is not just a clinical requirement; it is a vital part of matching the right vaccine to the right patient’s age, medical history, and lifestyle.

With options ranging from pneumococcal conjugate vaccines (PCVs), like PCV15, PCV20, and PCV21, to the polysaccharide PPSV23, the clinical choice depends on a symphony of factors including age and previous vaccination history. For instance, geography and lifestyle factors play a surprising role; while PCV20 provides coverage for serotype 4—a strain prevalent in unhoused populations in the Western US—other vaccines may be prioritized based on different risk profiles.

Gretchen K. Garofoli, PharmD, BCACP, CTTS, FAPhA, clinical professor at the West Virginia University School of Pharmacy, joined Drug Topics to provide her expert immunization knowledge within the pneumococcal vaccination arena. Addressing a variety of factors that both patients and pharmacists must navigate regarding these vaccines, Garofoli explored some of the key questions circulating pharmacy practices across the country.

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What types of pneumococcal vaccines exist, and which ones are the safest and most effective?

There are 2 types of pneumococcal vaccines: pneumococcal conjugate vaccines (PCV15, PCV20, and PCV21) and a pneumococcal polysaccharide vaccine (PPSV23). Each of these vaccines is approved to prevent pneumococcal disease and protect against specific strains of pneumococcal bacteria. The number that follows the letters in each vaccine indicates the number of strains that each contains. They are all safe and effective but have different indications for administration, so it is important to know the recommendations for each vaccine.¹

What diseases are pneumococcal vaccines designed to protect against?

Pneumococcal vaccines are designed to protect against the strains that are included in each of the vaccines. Pneumococcal diseases can include pneumonia (lung infection), meningitis (brain and spinal cord infection), and bacteremia (bloodstream infection)—all of which can cause serious disease and potentially death. Milder infections from pneumococcal bacteria include ear infections and sinus infections.²

Is the pneumococcal vaccine something patients need to receive every year, similar to the influenza shot?

Pneumococcal vaccine recommendations have changed more than any other vaccine recommendations during my time in practice, which is why it is important for all of us to stay up to date with the latest vaccine recommendations through attending continuing education programs and also by referring to the most recent vaccination schedules from organizations such as the American Academy of Family Physicians, the American Academy of Pediatrics, and the CDC.

Patients do not need to receive a pneumococcal vaccine annually but based on their age and risk conditions. On the vaccination schedules, it is important to check the notes section to determine if it is recommended that a patient receives a pneumococcal vaccine based on their age, risk factors, as well as whether or not they received previous dose(s) of any pneumococcal vaccines.

In general, patients 50 years of age and older who have not previously received a pneumococcal vaccine should receive a dose of a PCV.

What factors do patients need to consider—whether it’s age, income level, sex, etc—when deciding on whether or not to receive a pneumococcal vaccine?

It is extremely important to look both at the age of a patient as well as their risk factors when reviewing immunization schedules to determine if a pneumococcal vaccine is recommended for an individual patient.

One other interesting thing to consider when choosing a PCV for a patient is that there are different strains in each of the vaccines. Serotype 4 is a strain that is oftentimes pointed out as it is in PCV20, but not in PCV21. In certain populations, specifically in the Western US as well as in the unhoused population, this serotype is more prevalent. When determining which product to utilize, not only the individual patient risk but also where they live and their lifestyle factors should be considered. In this population, you would recommend PCV20 to ensure coverage for serotype 4.³

Are there common side effects to look out for after receiving a pneumococcal vaccine?

Common side effects include injection site pain, swelling, tenderness, and/or redness. Loss of appetite, irritability, feeling tired, muscle aches, headaches, joint pain, and chills can occur.⁴

Does insurance typically cover the costs of pneumococcal vaccination?

Yes, insurance typically determines coverage of vaccines based on what is recommended by the Advisory Committee on Immunization Practices (ACIP), so if a patient falls into the category of being eligible to receive a pneumococcal vaccine by their age and/or their medical conditions, it should be covered.

Conclusion

Effective pneumococcal protection extends well beyond simply administering a shot; it requires a tailored approach that considers the unique risks and environments of every patient population. As vaccine recommendations continue to shift, pharmacists must remain the lead conductors in this preventative effort—staying up to date with continuing education and communicating clearly about the life-saving benefits of immunization. Optimizing care is about building a proactive shield that allows patients to improve their long-term health outcomes and quality of life with confidence.

READ MORE: Pneumococcal Resource Center

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REFERENCES

1. Types of pneumococcal vaccines. CDC. February 25, 2026. Accessed May 8, 2026. https://www.cdc.gov/pneumococcal/vaccines/types.html

2. Pneumococcal disease symptoms and complications. CDC. February 25, 2026. Accessed May 8, 2026. https://www.cdc.gov/pneumococcal/signs-symptoms/index.html

3. Pneumococcal vaccine recommendations. PneumoRecs VaxAdvisor. December 11, 2024. Accessed May 8, 2026. https://www2a.cdc.gov/vaccines/m/pneumo/over50yr.asp?ages=%E2%89%A550%20years

4. Pneumococcus: questions and answers. Immunize.org. February 18, 2025. Accessed May 8, 2026. https://www.immunize.org/wp-content/uploads/catg.d/p4213.pdf