The “pneumonia shot” has changed a lot in the last few years. There are new vaccines, simpler schedules, and since late 2024 a lower starting age. If you have not kept up, you are not alone. Here is where the recommendations stand, based on the CDC’s guidance as updated in February 2026.

What pneumococcal disease is

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae. The CDC explains that it can cause pneumonia, meningitis and bloodstream infections, as well as ear and sinus infections. Anyone can get it, but older adults and people with certain health conditions are at higher risk of serious illness. Vaccines protect against the types of the bacterium that cause most severe disease.

Who should get vaccinated

In October 2024, the CDC’s Advisory Committee on Immunization Practices voted to recommend a pneumococcal conjugate vaccine for all adults 50 and older who have not had one. Before that, the age-based recommendation started at 65. The committee pointed to higher disease rates in some groups aged 50 to 64 and to the value of one simple age rule. Many people in their fifties already live with one of the conditions listed below, often without thinking of themselves as high risk.

Adults 19 to 49 are also recommended to get vaccinated if they have a risk condition. The CDC’s list of risk conditions for adults includes:

  • Diabetes
  • Chronic heart disease, including heart failure (high blood pressure alone does not count)
  • Chronic lung disease, including COPD, emphysema and asthma
  • Chronic liver disease
  • Chronic kidney failure or nephrotic syndrome
  • Cigarette smoking or alcoholism
  • A weakened immune system, including from HIV, immune-suppressing medicines, radiation, or a missing or nonworking spleen
  • A cochlear implant or a cerebrospinal fluid leak

Which vaccines, and how many

There are two kinds of pneumococcal vaccine: conjugate vaccines (PCV15, PCV20 and PCV21, named for the number of bacterial types they cover) and an older polysaccharide vaccine (PPSV23). For adults 50 and older who have never had a conjugate vaccine, or whose history is unknown, the CDC’s current recommendations are:

  • One dose of PCV20 or PCV21. That completes the series for most people.
  • Or one dose of PCV15, followed by one dose of PPSV23 about a year later. The gap can be as short as 8 weeks for people with a weakened immune system, a cochlear implant or a cerebrospinal fluid leak.

For most people, the practical result is a single shot. The CDC adds that if PPSV23 is not available after PCV15, a dose of PCV20 or PCV21 may be given instead. For adults under 50 with a risk condition, the vaccine type and number of doses depend on age and vaccination history, so it is worth reviewing your record with your doctor rather than guessing.

If you were vaccinated before

Many people over 65 received the older vaccines, PCV13 and PPSV23. The CDC guidance depends on what you had:

  • If you already had PCV20 or PCV21, you are done.
  • If you had PPSV23 only, a conjugate vaccine is usually still recommended.
  • If you are 65 or older and had both PCV13 and PPSV23 (with the PPSV23 at or after 65), you and your doctor can decide together whether to add PCV20 or PCV21 or stop there.

Records can be hard to find, especially for people who split the year between two states. A list of your past vaccines with dates makes this easy to sort out; our article on moving your medical records to Florida has tips.

Side effects and coverage

The CDC lists pain, redness and swelling where the shot was given as common reactions in adults, along with tiredness, headache, chills, muscle aches and joint pain. Call 911 for trouble breathing or swelling of the face or throat after any vaccine. Medicare Part B covers pneumococcal vaccines, and Medicare.gov says you pay nothing when the provider accepts assignment.

Pneumococcal vaccine is one part of staying ahead of respiratory illness after 50, along with the yearly flu shot, RSV and shingles vaccines. Dr. Shtern can sort out your vaccine history and what you are due for as part of your preventive care. If you would like to meet her first, the first visit is a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.