Vaccinations for Pneumonia: Pneumovax 23 vs. Prevnar 13

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Each year in the US, a type of bacteria known as pneumococcal bacteria causes thousands of infections, such as meningitis (an infection of the brain and spinal cord covering), bloodstream infections, pneumonia and ear infections. It can also lead to death. Currently, two vaccines protect against pneumococcal disease and the complications it can cause: Pneumovax 23 and Prevnar 13.

But, which one is best for you and your loved ones?



What is the difference between Pneumovax 23 and Prevnar 13?

The main difference between the two is the range of bacteria that they can help protect against. Pneumovax 23 protects against 23 types of pneumococcal bacteria, while Prevnar 13 protects against 13 types of pneumococcal bacteria.

Recommendations for who should get each vaccine also differ, as well as how each may be administered. Read on for more.


Who should get Pneumovax 23 and/or Prevnar 13?

The CDC recommends all children younger than 2 years old and all adults 65 years or older get vaccinated against pneumococcal disease. In certain situations, other children and adults should also get pneumococcal vaccines.


Infants and children younger than 2 years of age

For all infants and children younger than 2 years of age, the pneumococcal vaccination schedule is simple. The CDC recommends a series of four doses of Prevnar 13 given at 2 months, 4 months, 6 months, and sometime between 12 and 15 months of age.


Adults 65 years of age and older

If you’re just starting the pneumococcal vaccination schedule and you’re age 65 or older (never received either vaccine or have an unknown vaccination history), the CDC recommends that you get Prevnar 13 followed by Pneumovax 23 at least one year later. However, depending on certain conditions—having immune deficiency, asplenia (lack of normal spleen function), an active cerebrospinal fluid leak or a cochlear implant—you may need to only wait eight weeks between the two.

All adults 65 years of age and older should get one dose of Pneumovax 23, regardless of whether or not they’ve previously received a pneumococcal vaccine. If you already got Prevnar 13, there’s no need to get it again after age 65. If not, you should get Prevnar 13 as well, waiting at least one year after getting your Pneumovax 23 vaccine.


People age 2 and older at higher risk for pneumococcal disease

The CDC recommends that people 2 years of age and older at a higher risk for pneumococcal disease get both vaccines, but special schedules apply. You’ll only ever need one dose of Prevnar 13, but you may need more than one dose Pneumovax 23. Talk to your doctor about your specific schedule if you have one or more of the following conditions:



Who should NOT get Pneumovax 23 or Prevnar 13?

Depending on age or certain health conditions, some people should not get certain vaccines and should wait before getting them. Talk to your doctor if any of these circumstances apply to you.

Before you get either Prevnar 13 or Pneumovax 23, tell your health provider if you have had any life-threatening allergic reaction to or have a severe allergy to pneumococcal vaccines or any vaccine containing diphtheria toxoid (like Tdap). Also, tell your health provider if you are not feeling well. In you have a minor illness like a cold, you can probably still get vaccinated, but if you have a more serious illness, you should probably wait until you recover.

Children younger than 2 years of age should not get Pneumovax 23. In addition, while there is no evidence that Pneumovax 23 is harmful to pregnant women or their babies, as a precaution, women who need Pneumovax 23 should get it before becoming pregnant, if possible.


What are the most common side effects of Pneumovax 23 and Prevnar 13?

As with most vaccines, there are possible side effects to pneumonia vaccines. Side effects are usually mild and go away on their own within a few days, but serious reactions can happen.

Common side effects of Prevnar 13 include the following:

Common side effects of Pneumovax 23 include the following:

Be sure to talk with your doctor if you experience any of these symptoms for a prolonged period of time.



How effective is each vaccine?

Vaccines help protect against disease, but no vaccine is 100% effective.

Studies show that at least one dose of Prevnar 13 protects 80% of babies from serious pneumococcal infections, 75% of adults age 65 and older from invasive pneumococcal disease, and 45% of adults age 65 and older from pneumococcal pneumonia.

Studies show that one dose of Pneumovax 23 protects 50% to 80% of healthy adults against invasive pneumococcal disease.


How are the vaccines administered?

Pneumovax 23 can be administered either subcutaneously or intramuscularly, while Prevnar 13 has to be administered intramuscularly.


How much do Pneumovax 23 and Prevnar 13 cost?

Pneumovax 23 and Prevnar 13 can be quite expensive without insurance. One dose of Pneumovax 23 costs around $200 cash price, while one dose of Prevnar 13 costs a little over $400 cash price. With a GoodRx coupon, you might be able to reduce your cost for these to around $100 and $200, respectively. Read here for information on how to use a GoodRx coupon for vaccines.


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Remember: The recommendations for who should get a pneumonia vaccination are based on risk factors and age, so be sure to talk to your doctor if you think you might need one. You should be able to receive both Pneumovax 23 and Prevnar 13 at your local pharmacy. Depending on which state you live in, these vaccines may not require a prescription. Be sure to reach out to your pharmacist for more information.

The CDC has more information about these vaccinations here. If you are still stuck on which vaccine you need, have a conversation with your doctor.


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