Pediatric Pneumococcal Vaccination Schedule

Routine Schedule for Healthy Children

The Centers for Disease Control and Prevention recommends that all healthy infants receive a 4-dose series of PCV13 at 2, 4, 6, and 12-15 months of age, with no additional pneumococcal vaccines needed after completing this series unless high-risk conditions develop 1, 2
The primary series should be administered at 2, 4, and 6 months of age, with a booster dose given at 12-15 months, at least 8 weeks after the third dose 1, 2
The minimum intervals between doses are 4 weeks for infants <1 year and 8 weeks for children ≥12 months 1, 2, 5

Children with high-risk conditions, such as immunocompromising conditions, functional or anatomic asplenia, cochlear implants, and cerebrospinal fluid leaks, require additional PCV13 doses and subsequent PPSV23 1, 2, 5
For high-risk children 24-71 months, if <3 doses were received before age 24 months, 2 doses of PCV13 should be given, 8 weeks apart, and if 3 doses were received before age 24 months, 1 dose of PCV13 should be given, at least 8 weeks after the most recent dose 1, 5

Premature infants (<37 weeks gestation) who are medically stable should receive PCV13 at the recommended chronologic age (not corrected age), concurrent with other routine vaccinations 3, 4
Children previously vaccinated with PCV7 should complete their series with PCV13, with a supplemental dose given at least 8 weeks after the last PCV7 dose for children 14-59 months who completed a 4-dose PCV7 series 1, 2, 5

Healthy children who complete the 4-dose PCV13 series maintain protection throughout childhood without requiring booster doses after age 5 years, with 97.4% efficacy against invasive pneumococcal disease caused by vaccine serotypes 6

PCV13 is safe, with only minor adverse events reported, including local reactions (10-20% of recipients) and fever ≥38°C (15-25% within first 2 days post-vaccination) 3

Do not use PPSV23 in children <2 years of age, as it is only indicated for children ≥2 years with specific high-risk conditions 3, 4
Do not delay vaccination if doses are missed, and do not give routine PCV13 to healthy children ≥5 years, as it is not recommended for this age group 2, 5
Do not forget to administer PPSV23 to high-risk children after completing PCV13, as this provides broader serotype coverage 1, 2, 4